person
Dr. Justin Anthony Heaton, DMD
Pediatric Dentist in Vancouver, Washington
NPI 1336436906

Justin Anthony Heaton is a Pediatric Dentist based in Gladstone, WA and is specialized in Pediatric Dentistry. Justin Anthony Heaton practices in Vancouver, WA and has the professional credentials of DMD. The NPI Number for Justin Anthony Heaton is 1336436906 and holds a License No. DE60739379 (Washington).

The current practice location address for Justin Anthony Heaton is 900 Ne 139Th St Ste 106, Vancouver, WA and can be reached out via phone at 360-604-9000 and via fax at 360-573-1417. You can also correspond with Justin Anthony Heaton through the mailing address at 7300 N MYRTLE AVE, GLADSTONE, MO - 64119-1978 (mailing address contact number: 208-569-4169).

Location: 900 Ne 139Th St Ste 106, Vancouver, WA, 64119-1978
person
Provider Profile Details
NPI Number
1336436906
Provider Name
Justin Anthony Heaton
Credential
DMD
Provider Entity Type
Individual
Gender
Male
Address
900 Ne 139Th St Ste 106, Vancouver, WA, 64119-1978
Phone Number
360-604-9000
Fax Number
360-573-1417
Provider Enumeration Date
07/05/2011
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
00202327 01 CO COLORADO DENTAL BOARD
8021817-9922 01 UT UTAH STATE DENTAL BOARD
DD4183 01 NM NEW MEXICO DENTAL BOARD
2015004889 01 MO MISSOURI DENTAL BOARD
institution
Provider Business Practice Location Address Details
Address
900 Ne 139Th St Ste 106
City
State
Zip
98685
Phone Number
360-604-9000
Fax Number
360-573-1417
person
Provider Business Mailing Address Details
Address
900 Ne 139Th St Ste 106
City
State
Zip
98685
Phone Number
360-604-9000
Fax Number
360-573-1417
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Pediatric Dentistry
Taxonomy
License No.
DE60739379 (Washington)
Definition
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
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