Individual
DR. CARLOS ANTOLIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
8700 NE VANCOUVER MALL DR, SUITE 202, VANCOUVER, WA 98662-6750
(360) 254-8880
Mailing address
1101 SE TECH CENTER DR, SUITE 195, VANCOUVER, WA 98683-5504
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D7762
WA
Other
Enumeration date
03/29/2007
Last updated
07/08/2007
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