Provider Demographics
NPI:1952717894
Name:MCQUIRTER, DIANA IRIS (DDS)
Entity Type:Individual
Prefix:DR
First Name:DIANA
Middle Name:IRIS
Last Name:MCQUIRTER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28755 DEQUINDRE RD
Mailing Address - Street 2:
Mailing Address - City:MADISON HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48071-3005
Mailing Address - Country:US
Mailing Address - Phone:248-399-4011
Mailing Address - Fax:
Practice Address - Street 1:28755 DEQUINDRE RD
Practice Address - Street 2:
Practice Address - City:MADISON HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48071-3005
Practice Address - Country:US
Practice Address - Phone:248-399-4011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-10
Last Update Date:2016-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901021354122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist