Individual
DR. SUSANNAH FAYE BOHANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
4210 MARTIN WAY E, #101, OLYMPIA, WA 98516-5325
(360) 455-9544
Mailing address
4210 MARTIN WAY E, #101, OLYMPIA, WA 98516-5325
(360) 455-9544
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DE60034344
WA
Other
Enumeration date
04/24/2009
Last updated
04/24/2009
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