Provider Demographics
NPI:1346203395
Name:QUICK, DONNY LYNN (DDS ORAL SURGEON)
Entity type:Individual
Prefix:DR
First Name:DONNY
Middle Name:LYNN
Last Name:QUICK
Suffix:
Gender:M
Credentials:DDS ORAL SURGEON
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2425 PRINCE ST
Mailing Address - Street 2:STE 2
Mailing Address - City:CONWAY
Mailing Address - State:AR
Mailing Address - Zip Code:72034-3746
Mailing Address - Country:US
Mailing Address - Phone:501-329-3223
Mailing Address - Fax:501-329-8939
Practice Address - Street 1:2425 PRINCE ST
Practice Address - Street 2:STE 2
Practice Address - City:CONWAY
Practice Address - State:AR
Practice Address - Zip Code:72034-3746
Practice Address - Country:US
Practice Address - Phone:501-329-3223
Practice Address - Fax:501-329-8939
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR33421223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
U99191Medicare UPIN