Individual
ASHANTI ITZEL QUINTANA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
748 SW 3RD ST, MADRAS, OR 97741-1126
(541) 390-7176
Mailing address
748 SW 3RD ST, MADRAS, OR 97741-1126
(541) 390-7176
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
09/30/2024
Last updated
09/30/2024
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