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Individual

MS. BETHANY CARMELA JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
2300 LANCASTER DR NE, SALEM, OR 97305-1223
(503) 370-4313
Mailing address
2300 LANCASTER DR NE, SALEM, OR 97305-1223
(503) 370-4313

Taxonomy

Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary

Other

Enumeration date
05/08/2012
Last updated
05/08/2012
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