Organization
K Q DENTAL PC
Active
Other names
Pine Lake Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDWARD E. QUINCY D.D.S. (PRESIDENT)
(402) 447-6042
Entity
Organization
Contact information
Practice address
2504 NORTH WEBB RD, GRAND ISLAND, NE 68803
(308) 381-7077
(308) 381-1345
Mailing address
PO BOX 87, NEWMAN GROVE, NE 68758
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
3376
NE
1223G0001X
General Practice Dentistry
3530
NE
1223G0001X
General Practice Dentistry
4467
NE
1223G0001X
General Practice Dentistry
4543
NE
1223G0001X
General Practice Dentistry
5343
NE
1223G0001X
General Practice Dentistry
5746
NE
1223G0001X
General Practice Dentistry
5838
NE
1223G0001X
General Practice Dentistry
5954
NE
1223G0001X
General Practice Dentistry
5962
NE
1223G0001X
General Practice Dentistry
6365
NE
1223G0001X
General Practice Dentistry
6759
NE
1223G0001X
General Practice Dentistry
Primary
6834
NE
1223G0001X
General Practice Dentistry
6837
—
Other
Enumeration date
11/15/2006
Last updated
07/06/2009
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