Provider Demographics
NPI:1285159004
Name:C. ALAN MCQUIGG DDS MS PC
Entity type:Organization
Organization Name:C. ALAN MCQUIGG DDS MS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:MCQUIGG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:417-623-8232
Mailing Address - Street 1:PO BOX 349
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:OK
Mailing Address - Zip Code:74355-0349
Mailing Address - Country:US
Mailing Address - Phone:417-623-8232
Mailing Address - Fax:417-623-4426
Practice Address - Street 1:620 W 32ND ST STE C
Practice Address - Street 2:
Practice Address - City:JOPLIN
Practice Address - State:MO
Practice Address - Zip Code:64804-2528
Practice Address - Country:US
Practice Address - Phone:141-762-3823
Practice Address - Fax:417-623-8232
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:C. ALAN MCQUIGG DDS, MS PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-08-14
Last Update Date:2017-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20090146281223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0700XDental ProvidersDentistProsthodonticsGroup - Single Specialty