Provider Demographics
NPI:1750548624
Name:QUIGLEY, JOHN IVAR (DDS)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:IVAR
Last Name:QUIGLEY
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 1:2774 E 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80206-4808
Mailing Address - Country:US
Mailing Address - Phone:303-503-7274
Mailing Address - Fax:303-355-0014
Practice Address - Street 1:2774 E 2ND AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80206-4808
Practice Address - Country:US
Practice Address - Phone:303-503-7274
Practice Address - Fax:303-355-0014
Is Sole Proprietor?:No
Enumeration Date:2008-05-19
Last Update Date:2008-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO68041223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice