| Mark D. Johnson D.d.s., P.s. | |
|
6927 Lakewood Dr W Ste C2 Tacoma WA 98467-3247 | |
| (253) 565-1695 | |
| (253) 565-1588 |
| Full Name | Mark D. Johnson D.d.s., P.s. |
|---|---|
| Speciality | Dentist |
| Location | 6927 Lakewood Dr W Ste C2, Tacoma, Washington |
| Authorized Official Name and Position | Mark Douglas Johnson (DENTIST) |
| Authorized Official Contact | 2535651695 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mark D. Johnson D.d.s., P.s. 6927 Lakewood Dr W Ste C2 Tacoma WA 98467-3247 Ph: (253) 565-1695 | Mark D. Johnson D.d.s., P.s. 6927 Lakewood Dr W Ste C2 Tacoma WA 98467-3247 Ph: (253) 565-1695 |
| NPI Number | 1801022934 |
|---|---|
| Provider Enumeration Date | 06/03/2009 |
| Last Update Date | 06/03/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801022934 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DE00005841 (Washington) | Primary |
| 122300000X | Dentist | DE60096175 (Washington) | Secondary |
Olympic Dental & Denture Center, Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 3720 6th Ave, Suite A, Tacoma, WA 98406 Phone: 253-752-1320 Fax: 253-752-1425 | |
Bansuk Ju Dds Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2302 S Union Ave Ste A6, Tacoma, WA 98405 Phone: 253-752-4422 | |