Provider Demographics
NPI:1528627213
Name:QUICK, FORREST GILLETTE (DMD)
Entity type:Individual
Prefix:
First Name:FORREST
Middle Name:GILLETTE
Last Name:QUICK
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:653-1 WEST 8TH STREET
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32209
Mailing Address - Country:US
Mailing Address - Phone:904-244-2000
Mailing Address - Fax:904-244-6105
Practice Address - Street 1:653-1 WEST 8TH STREET
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32209
Practice Address - Country:US
Practice Address - Phone:904-244-2000
Practice Address - Fax:904-244-6105
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-06
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODEN.002040781223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice