Provider Demographics
NPI:1891276614
Name:LEAR, QUINN A (DMD)
Entity Type:Individual
Prefix:
First Name:QUINN
Middle Name:A
Last Name:LEAR
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:JOEL DENTAL CLINIC BLDG M4861 LOGISTICS AVE
Mailing Address - Street 2:
Mailing Address - City:FORT LIBERTY
Mailing Address - State:NC
Mailing Address - Zip Code:28310-0001
Mailing Address - Country:US
Mailing Address - Phone:910-907-9060
Mailing Address - Fax:
Practice Address - Street 1:JOEL DENTAL CLINIC BLDG M4861 LOGISTICS AVE
Practice Address - Street 2:
Practice Address - City:FORT LIBERTY
Practice Address - State:NC
Practice Address - Zip Code:28310-5095
Practice Address - Country:US
Practice Address - Phone:910-907-9060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-29
Last Update Date:2023-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019031864122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist