Provider Demographics
NPI:1134332497
Name:HUISON K QUON DDS LLC
Entity type:Organization
Organization Name:HUISON K QUON DDS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:HUISON
Authorized Official - Middle Name:K
Authorized Official - Last Name:QUON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:301-337-6211
Mailing Address - Street 1:501 N FREDERICK AVE STE 206
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20877-2545
Mailing Address - Country:US
Mailing Address - Phone:301-337-6211
Mailing Address - Fax:301-337-6212
Practice Address - Street 1:501 N FREDERICK AVE STE 206
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20877-2545
Practice Address - Country:US
Practice Address - Phone:301-337-6211
Practice Address - Fax:301-337-6212
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-07
Last Update Date:2019-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD10366122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty