Provider Demographics
NPI:1992820393
Name:QUINN DENTAL P.A.
Entity type:Organization
Organization Name:QUINN DENTAL P.A.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:ARTHUR
Authorized Official - Last Name:QUINN
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:651-452-9660
Mailing Address - Street 1:3938 CEDAR GROVE PKWY
Mailing Address - Street 2:
Mailing Address - City:EAGAN
Mailing Address - State:MN
Mailing Address - Zip Code:55122-1403
Mailing Address - Country:US
Mailing Address - Phone:651-452-9660
Mailing Address - Fax:651-406-8544
Practice Address - Street 1:3938 CEDAR GROVE PKWY
Practice Address - Street 2:
Practice Address - City:EAGAN
Practice Address - State:MN
Practice Address - Zip Code:55122-1403
Practice Address - Country:US
Practice Address - Phone:651-452-9660
Practice Address - Fax:651-406-8544
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN8042261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1275694606OtherNPI
MN1578640272OtherNPI
MN1619034378OtherNPI
MN1992862601OtherNPI