Provider Demographics
NPI:1689688574
Name:QUINN, KEVIN W (DMD)
Entity Type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:W
Last Name:QUINN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:74 FAUNCE CORNER RD
Mailing Address - Street 2:SUITE 620
Mailing Address - City:N DARTMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02747
Mailing Address - Country:US
Mailing Address - Phone:508-997-2999
Mailing Address - Fax:508-997-5099
Practice Address - Street 1:74 FAUNCE CORNER RD
Practice Address - Street 2:SUITE 620
Practice Address - City:N DARTMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02747
Practice Address - Country:US
Practice Address - Phone:508-997-2999
Practice Address - Fax:508-997-5099
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA204901223P0300X
RIDEN027401223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics