Provider Demographics
NPI:1063590339
Name:CONWAY-QUINN, DOROTHY J (DMD)
Entity type:Individual
Prefix:DR
First Name:DOROTHY
Middle Name:J
Last Name:CONWAY-QUINN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 N KINGS HIGHWAY STE 100A
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08034-2304
Mailing Address - Country:US
Mailing Address - Phone:856-795-0900
Mailing Address - Fax:856-795-0994
Practice Address - Street 1:1500 N KINGS HIGHWAY STE 100A
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08034-2304
Practice Address - Country:US
Practice Address - Phone:856-795-0900
Practice Address - Fax:856-795-0994
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJD117741122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
582306OtherUNITED CONCORDIA