# AJ FAMILY DENTISTRY

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

## Provider details

- **NPI number:** 1750699377
- **Authorized official:** DR. JOHNNY TY TIEN DDS (PRESIDENT)
- **Authorized official phone:** (253) 332-5457

## Contact information

- **Practice address:** 921 VERNON RD, LAKE STEVENS, WA 98258-7931
- **Practice address phone:** (425) 610-4751
- **Practice address fax:** (425) 610-4751
- **Mailing address:** 11820 57TH AVE SE, SNOHOMISH, WA 98296-6974
- **Mailing address phone:** (425) 610-4751
- **Mailing address fax:** (425) 610-4753

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | DE9339 | WA | Yes |

## Other

- **Enumeration date:** 09/16/2010
- **Last updated:** 09/16/2010