Provider Demographics
NPI:1659050425
Name:QUAN, DUY BAO (DMD)
Entity type:Individual
Prefix:DR
First Name:DUY
Middle Name:BAO
Last Name:QUAN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:MEDDAC-BAVARIA CMR 411
Mailing Address - Street 2:APO/AE 09112
Mailing Address - City:ANSBACH
Mailing Address - State:BAVARIA
Mailing Address - Zip Code:09112
Mailing Address - Country:DE
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:MEDDAC-BAVARIA CMR 411 APO/AE 09112
Practice Address - Street 2:
Practice Address - City:ANSBACH
Practice Address - State:BAVARIA
Practice Address - Zip Code:09112
Practice Address - Country:DE
Practice Address - Phone:637-194-6436
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-17
Last Update Date:2024-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0441511223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice