Organization
OJH CLINIC #6 INC.
Active
Other names
Bonney Lake Family Dental Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. OTTO JULIUS HANSSEN D.D.S. (PRESIDENT)
(253) 826-9000
Entity
Organization
Contact information
Practice address
21515 STATE ROUTE 410 E, SUITE A, BONNEY LAKE, WA 98391-4100
(253) 826-9000
(253) 826-0328
Mailing address
21515 STATE ROUTE 410 E, SUITE A, BONNEY LAKE, WA 98391-4100
(253) 826-9000
(253) 826-0328
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
WA
Other
Enumeration date
01/24/2007
Last updated
08/22/2020
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