Provider Demographics
NPI:1740856699
Name:QUIBEUF, LINDSEY (DMD)
Entity type:Individual
Prefix:DR
First Name:LINDSEY
Middle Name:
Last Name:QUIBEUF
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6668 GREEN PLANTATION RD
Mailing Address - Street 2:
Mailing Address - City:HARLEM
Mailing Address - State:GA
Mailing Address - Zip Code:30814-5004
Mailing Address - Country:US
Mailing Address - Phone:706-251-5247
Mailing Address - Fax:
Practice Address - Street 1:540 W HILL ST
Practice Address - Street 2:
Practice Address - City:THOMSON
Practice Address - State:GA
Practice Address - Zip Code:30824-2117
Practice Address - Country:US
Practice Address - Phone:706-595-5152
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-01
Last Update Date:2021-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0161661223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice