Provider Demographics
NPI:1386485944
Name:MCQUIN, PAYTON JAMES (DDS)
Entity type:Individual
Prefix:
First Name:PAYTON
Middle Name:JAMES
Last Name:MCQUIN
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 1:308 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HOKAH
Mailing Address - State:MN
Mailing Address - Zip Code:55941-7717
Mailing Address - Country:US
Mailing Address - Phone:608-799-0722
Mailing Address - Fax:
Practice Address - Street 1:1831 E MAIN ST
Practice Address - Street 2:
Practice Address - City:ONALASKA
Practice Address - State:WI
Practice Address - Zip Code:54650-8757
Practice Address - Country:US
Practice Address - Phone:608-783-6384
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-05
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND150781223G0001X
WI6001468-151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice