# TIMOTHY QUIRT, MONGRAIN, GIBREE, P.C.

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** TIMOTHY QUIRT, MONGRAIN, GIBREE, P.C.
- **Other names:** Main Street Dental Care
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1275353989
- **Legal business name:** TIMOTHY QUIRT, MONGRAIN, GIBREE, P.C.
- **Authorized official:** CEMYIRA MCDOUGAL (CREDENTIALING COORDINATOR)
- **Authorized official phone:** (217) 764-8609

## Contact information

- **Practice address:** 623 W MAIN ST, MONROE, WA 98272-2101
- **Practice address phone:** (360) 805-9060
- **Mailing address:** 623 W MAIN ST, MONROE, WA 98272-2101
- **Mailing address phone:** (360) 805-9060

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | NULL | Yes |
| 122300000X | Dentist | — | — | Yes |

## Other

- **Enumeration date:** 10/16/2024
- **Last updated:** 12/04/2024