Provider Demographics
NPI:1245314848
Name:QUAN, BRIAN (DDS)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:
Last Name:QUAN
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 1:595 BUCKINGHAM WAY
Mailing Address - Street 2:SUITE 540
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94132-1909
Mailing Address - Country:US
Mailing Address - Phone:415-661-7420
Mailing Address - Fax:415-661-8949
Practice Address - Street 1:595 BUCKINGHAM WAY
Practice Address - Street 2:SUITE 540
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94132-1909
Practice Address - Country:US
Practice Address - Phone:415-661-7420
Practice Address - Fax:415-661-8949
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA48666122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist