Provider Demographics
NPI:1154734150
Name:KHUE QUAN, DDS, INC
Entity type:Organization
Organization Name:KHUE QUAN, DDS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KHUE
Authorized Official - Middle Name:
Authorized Official - Last Name:QUAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:714-897-9985
Mailing Address - Street 1:14571 MAGNOLIA ST STE 202
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92683-5576
Mailing Address - Country:US
Mailing Address - Phone:714-897-9985
Mailing Address - Fax:
Practice Address - Street 1:14571 MAGNOLIA ST STE 202
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683-5576
Practice Address - Country:US
Practice Address - Phone:714-897-9985
Practice Address - Fax:714-897-9989
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-06
Last Update Date:2014-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA414661223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty