Provider Demographics
NPI:1083099519
Name:QUINTON, CARSTEN BRADLEY (DDS)
Entity Type:Individual
Prefix:DR
First Name:CARSTEN
Middle Name:BRADLEY
Last Name:QUINTON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 N 39TH PL
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:WA
Mailing Address - Zip Code:98273-9403
Mailing Address - Country:US
Mailing Address - Phone:360-770-2183
Mailing Address - Fax:
Practice Address - Street 1:275 SE CABOT DR STE A1
Practice Address - Street 2:
Practice Address - City:OAK HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98277
Practice Address - Country:US
Practice Address - Phone:360-675-2222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-27
Last Update Date:2018-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX31273122300000X
WADE60837881122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist