Organization
KENT JOHANSEN, DDS, PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENT JOHANSEN DDS (OWNER)
(480) 345-0530
Entity
Organization
Contact information
Practice address
3800 W RAY RD, SUITE 11, CHANDLER, AZ 85226-5940
(480) 345-0530
(480) 345-0048
Mailing address
3800 W RAY RD, SUITE 11, CHANDLER, AZ 85226-5940
(480) 345-0530
(480) 345-0048
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3035
AZ
Other
Enumeration date
03/22/2007
Last updated
08/22/2020
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