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Organization
JOHNSON, DIXSON & POND DENTISTRY
Active
Organization
JOHNSON, DIXSON & POND DENTISTRY
Active
Other names
Smiles Family Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEROMY R. DIXSON DMD (PARTNER)
(360) 577-0566
Entity
Organization
Contact information
Practice address
820 OCEAN BEACH HWY,, STE 110, LONGVIEW, WA 98632-4011
(360) 577-0566
(360) 425-6935
Mailing address
820 OCEAN BEACH HWY, STE 110, LONGVIEW, WA 98632-4080
(360) 577-0566
(360) 425-6935
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
DE00008175
WA
1223G0001X
General Practice Dentistry
Primary
DE00009942
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1205926110
NPI- PERSONAL
WA
05
—
5046164
—
WA
Enumeration date
03/28/2007
Last updated
03/18/2010
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