Organization
AJ FAMILY DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHNNY TY TIEN DDS (PRESIDENT)
(253) 332-5457
Entity
Organization
Contact information
Practice address
921 VERNON RD, LAKE STEVENS, WA 98258-7931
(425) 610-4751
(425) 610-4751
Mailing address
11820 57TH AVE SE, SNOHOMISH, WA 98296-6974
(425) 610-4751
(425) 610-4753
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
DE9339
WA
Other
Enumeration date
09/16/2010
Last updated
09/16/2010
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