# QUINCY ORAL & MAXILLOFACIAL SURGERY, P.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1316120033
- **Authorized official:** DANIEL RIGGS (VICE-PRESIDENT)
- **Authorized official phone:** (217) 222-9434

## Contact information

- **Practice address:** 3915 MAINE ST, SUITE 3, QUINCY, IL 62305-5843
- **Practice address phone:** (217) 222-9434
- **Practice address fax:** (217) 222-0671
- **Mailing address:** 3915 MAINE ST, SUITE 3, QUINCY, IL 62305-5843
- **Mailing address phone:** (217) 222-9434
- **Mailing address fax:** (217) 222-0671

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NULL | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | Yes |

## Other

- **Enumeration date:** 12/17/2007
- **Last updated:** 08/22/2008