Individual
DR. DANIEL QUON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
5800 RIDGEWOOD RD, STE 102, JACKSON, MS 39211-2667
(601) 957-1207
(601) 957-0602
Mailing address
5800 RIDGEWOOD RD, STE 102, JACKSON, MS 39211-2667
(601) 957-1207
(601) 957-0602
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
1849-79
MS
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
1849-79
MS
Other
Enumeration date
05/24/2005
Last updated
05/06/2015
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