Individual
CARLOS DORANTES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
6201 SUMMITVIEW AVE, SUITE 100, YAKIMA, WA 98908-3027
(509) 966-4433
(509) 966-1021
Mailing address
6201 SUMMITVIEW AVE, SUITE 100, YAKIMA, WA 98908-3027
(509) 966-4433
(509) 966-1021
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DE00009567
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0172070
L & I
WA
05
—
5044078
—
WA
01
—
911019392
COMMERCIAL
—
Enumeration date
10/03/2006
Last updated
11/27/2012
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