| Adventure Dental | |
|
900 Ne 139th St Suite 106 Vancouver WA 98685 | |
| (360) 604-9000 | |
| (360) 573-1417 |
| Full Name | Adventure Dental |
|---|---|
| Speciality | Dentist |
| Location | 900 Ne 139th St, Vancouver, Washington |
| Authorized Official Name and Position | Justin Anthony Heaton (DENTIST/OWNER) |
| Authorized Official Contact | 3606049000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Adventure Dental 900 Ne 139th St Suite 106 Vancouver WA 98685 Ph: (360) 604-9000 | Adventure Dental 900 Ne 139th St Suite 106 Vancouver WA 98685 Ph: (360) 604-9000 |
| NPI Number | 1558511923 |
|---|---|
| Provider Enumeration Date | 09/23/2008 |
| Last Update Date | 11/08/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558511923 | NPI | - | NPPES |
| 1092108 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
| 1223P0221X | Dentist - Pediatric Dentistry | DE00010959 (Washington) | Secondary |
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