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Organization
TRACY R. JOHNSON, DDS, PS
Active
Organization
TRACY R. JOHNSON, DDS, PS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TRACY R JOHNSON DDS (PRESIDENT/OWNER)
(360) 895-8841
Entity
Organization
Contact information
Practice address
2040 MITCHELL RD SE, PORT ORCHARD, WA 98366-4401
(360) 895-8841
(360) 895-9350
Mailing address
3377 BETHEL RD SE STE 107, PMB 184, PORT ORCHARD, WA 98366-5608
(360) 895-8841
(360) 895-9350
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DE00008961
WA
Other
Enumeration date
04/24/2008
Last updated
04/24/2008
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