Provider Demographics
NPI:1437137569
Name:PAYNTER, MITCHELL MATTHEW (DMD)
Entity Type:Individual
Prefix:DR
First Name:MITCHELL
Middle Name:MATTHEW
Last Name:PAYNTER
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 1:1419 OAKES AVE
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98201-1630
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:NAVAL HOSPITAL OAK HARBOR NAS WHIDBEY ISLAND
Practice Address - Street 2:3475 N. SARATOGA ST
Practice Address - City:OAK HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98278-0001
Practice Address - Country:US
Practice Address - Phone:360-257-2301
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE000095441223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice