Organization
CHANDLER PDC PLLC
Active
Other names
Johansen Dental
Organization subpart
No
Provider details
NPI number
Authorized official
MARK CHRISTENSEN (CREDENTIALING SPECIALIST)
(801) 305-3460
Entity
Organization
Contact information
Practice address
3800 W RAY RD STE 11, CHANDLER, AZ 85226-5940
(480) 345-0530
Mailing address
355 S 520 W STE 250, LINDON, UT 84042-1976
(801) 305-3460
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
03/14/2024
Last updated
03/14/2024
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