Organization
MARK D. JOHNSON D.D.S., P.S.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK DOUGLAS JOHNSON DDS (DENTIST)
(253) 565-1695
Entity
Organization
Contact information
Practice address
6927 LAKEWOOD DR W STE C2, TACOMA, WA 98467-3247
(253) 565-1695
(253) 565-1588
Mailing address
6927 LAKEWOOD DR W STE C2, TACOMA, WA 98467-3247
(253) 565-1695
(253) 565-1588
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DE00005841
WA
122300000X
Dentist
DE60096175
WA
Other
Enumeration date
06/03/2009
Last updated
06/03/2009
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