# COLLEEN QUESADA DMD PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Farwell Family Dentistry
- **Organization subpart:** No

## Provider details

- **NPI number:** 1982861829
- **Authorized official:** DR. COLLEEN S QUESADA D.M.D (OWNER)
- **Authorized official phone:** (989) 588-4121

## Contact information

- **Practice address:** 301 W MAIN ST, FARWELL, MI 48622-8753
- **Practice address phone:** (989) 588-4121
- **Practice address fax:** (989) 588-3191
- **Mailing address:** 301 W MAIN ST, PO BOX 309, FARWELL, MI 48622-8753
- **Mailing address phone:** (989) 588-4121
- **Mailing address fax:** (989) 588-3191

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 18173 | MI | Yes |

## Other

- **Enumeration date:** 05/19/2008
- **Last updated:** 05/19/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | D801268 | BCBS OF MI PIN | MI |