Individual
DR. BRYCE QUINN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
2115 EXECUTIVE DR, SUITE 8C, HAMPTON, VA 23666-2499
(756) 838-1664
Mailing address
2115 EXECUTIVE DR, SUITE 8C, HAMPTON, VA 23666-2499
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401413632
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0401413632
DENTAL PROVIDER NUMBER
VA
Enumeration date
10/02/2012
Last updated
10/02/2012
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