# OJH CLINIC NO 1 INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Covington Family Dentistry
- **Organization subpart:** No

## Provider details

- **NPI number:** 1477767333
- **Authorized official:** DR. OTTO J HANSSEN DDS (DENTIST OWNER)
- **Authorized official phone:** (253) 630-4400

## Contact information

- **Practice address:** 17224 SE 272ND STREET, COVINGTON, WA 98042
- **Practice address phone:** (253) 630-4400
- **Practice address fax:** (253) 631-2267
- **Mailing address:** 17224 SE 272ND STREET, COVINGTON, WA 98042
- **Mailing address phone:** (253) 630-4400
- **Mailing address fax:** (253) 631-2267

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 5262 | NULL | Yes |
| 1223G0001X | General Practice Dentistry | 5262 | — | Yes |

## Other

- **Enumeration date:** 05/10/2007
- **Last updated:** 08/22/2020