# OLYMPIC DENTAL & DENTURE CENTER, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003148719
- **Authorized official:** RICHARD C JOHNSON L.D, (CEO)
- **Authorized official phone:** (253) 752-1320

## Contact information

- **Practice address:** 3720 6TH AVE, SUITE A, TACOMA, WA 98406-4938
- **Practice address phone:** (253) 752-1320
- **Practice address fax:** (253) 752-1425
- **Mailing address:** 3720 6TH AVE, SUITE A, TACOMA, WA 98406-4938
- **Mailing address phone:** (253) 752-1320
- **Mailing address fax:** (253) 752-1425

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | 416 | WA | Yes |

## Other

- **Enumeration date:** 02/04/2010
- **Last updated:** 02/04/2010