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Organization
MARK D. JOHNSON D.D.S., P.S.
Active
Organization
MARK D. JOHNSON D.D.S., P.S.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK DOUGLAS JOHNSON DDS (DENTIST)
(253) 565-1695
Entity
Organization
Contact information
Practice address
6927 LAKEWOOD DR W STE C2, TACOMA, WA 98467-3247
(253) 565-1695
(253) 565-1588
Mailing address
6927 LAKEWOOD DR W STE C2, TACOMA, WA 98467-3247
(253) 565-1695
(253) 565-1588
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DE00005841
WA
122300000X
Dentist
DE60096175
WA
Other
Enumeration date
06/03/2009
Last updated
06/03/2009
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