Provider Demographics
NPI:1679684633
Name:QUAIN, PATRICK LEO (DDS)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:LEO
Last Name:QUAIN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 S CREYTS RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48917
Mailing Address - Country:US
Mailing Address - Phone:517-321-1881
Mailing Address - Fax:517-321-0115
Practice Address - Street 1:701 S CREYTS RD
Practice Address - Street 2:SUITE B
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48917
Practice Address - Country:US
Practice Address - Phone:517-321-1881
Practice Address - Fax:517-321-0115
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI012974122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist