Individual
DR. ERIC L QUILLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
156 FRANKFORT STREET, VERSAILLES, KY 40383
(859) 879-5045
Mailing address
156 FRANKFORT STREET, VERSAILLES, KY 40383
(859) 879-5045
(859) 879-5045
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
2241
WV
122300000X
Dentist
7449
KY
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
59
WV
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
653
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
60003100
—
KY
Enumeration date
08/30/2006
Last updated
05/04/2015
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