Individual
QUINN MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1683 W HARVARD AVE, ROSEBURG, OR 97471-2812
(541) 706-9445
Mailing address
1683 W HARVARD AVE, ROSEBURG, OR 97471-2812
(541) 706-9445
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D10219
OR
1223G0001X
General Practice Dentistry
D4603
ID
Other
Enumeration date
07/06/2014
Last updated
07/06/2015
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