Provider Demographics
NPI:1225862410
Name:QC DENTAL PLLC
Entity type:Organization
Organization Name:QC DENTAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:KRISTI
Authorized Official - Middle Name:M
Authorized Official - Last Name:QUAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:931-647-0838
Mailing Address - Street 1:1754 MADISON ST STE 4
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37043-2924
Mailing Address - Country:US
Mailing Address - Phone:931-647-0838
Mailing Address - Fax:931-648-3840
Practice Address - Street 1:1754 MADISON ST STE 4
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37043-2924
Practice Address - Country:US
Practice Address - Phone:931-647-0838
Practice Address - Fax:931-648-3840
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-29
Last Update Date:2024-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty