Individual
QUINN MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
B.D.S
Contact information
Practice address
128 E PRAIRIE ST, SEQUIM, WA 98382-3818
(360) 504-3636
(360) 504-3536
Mailing address
128 E PRAIRIE ST, HERITAGE ENDODONTICS, SEQUIM, WA 98382-3818
(360) 504-3636
(360) 504-3536
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
60055426
WA
1223E0200X
Endodontics
DN 19447
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004716800
—
FL
01
—
DN19447
STATE LICENSE
FL
Enumeration date
03/02/2012
Last updated
02/22/2016
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