# KEVIN LEE DDS JOHANN TI DDS & MICHAEL HYODO DDS PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Stanwood Dental Care
- **Organization subpart:** No

## Provider details

- **NPI number:** 1881700920
- **Authorized official:** MR. JOHANN M TI DDS (PARTNER)
- **Authorized official phone:** (360) 629-1776

## Contact information

- **Practice address:** 9612 270TH ST NW, 7C, STANWOOD, WA 98292
- **Practice address phone:** (360) 629-1776
- **Practice address fax:** (360) 629-0541
- **Mailing address:** 9612 270TH ST NW, 7C, STANWOOD, WA 98292
- **Mailing address phone:** (360) 629-1776
- **Mailing address fax:** (360) 629-0541

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | 6284 | WA | — |
| 261QD0000X | Dental Clinic/Center | 7741 | WA | — |
| 261QD0000X | Dental Clinic/Center | 8211 | WA | Yes |
| 261QD0000X | Dental Clinic/Center | 9599 | WA | — |

## Other

- **Enumeration date:** 08/22/2006
- **Last updated:** 08/22/2020