Organization
OLYMPIC DENTAL & DENTURE CENTER,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICHARD C JOHNSON LD (OWNER)
(253) 752-1320
Entity
Organization
Contact information
Practice address
3720 6TH AVE STE A, TACOMA, WA 98406-4938
(253) 752-1320
(253) 752-1425
Mailing address
3720 6TH AVE STE A, TACOMA, WA 98406-4938
(253) 752-1320
(253) 752-1425
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2050411
UNITED CONCORDIA
WA
05
—
5056817
—
WA
Enumeration date
03/27/2007
Last updated
02/11/2010
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