Provider Demographics
NPI:1215913587
Name:QUIRAM, PAUL J (DDS)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:J
Last Name:QUIRAM
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:PO BOX 518
Mailing Address - Street 2:338 WEST BROADWAY
Mailing Address - City:PLAINVIEW
Mailing Address - State:MN
Mailing Address - Zip Code:55964-0518
Mailing Address - Country:US
Mailing Address - Phone:507-534-3127
Mailing Address - Fax:507-534-2990
Practice Address - Street 1:338 W BROADWAY
Practice Address - Street 2:
Practice Address - City:PLAINVIEW
Practice Address - State:MN
Practice Address - Zip Code:55964-1256
Practice Address - Country:US
Practice Address - Phone:507-534-3127
Practice Address - Fax:507-534-2990
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNMND10446122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist