Provider Demographics
NPI:1760970925
Name:CARSTEN B. QUINTON, DDS, PLLC
Entity Type:Organization
Organization Name:CARSTEN B. QUINTON, DDS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CARSTEN
Authorized Official - Middle Name:BRADLEY
Authorized Official - Last Name:QUINTON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:360-770-2183
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:98277-3740
Practice Address - Country:US
Practice Address - Phone:360-675-2222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-24
Last Update Date:2018-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE60837881261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
1083099519OtherPERSONAL NPI