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Organization

JOHNSON, DIXSON & POND DENTISTRY

Active
Other names
Smiles Family Dental
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JEROMY R. DIXSON DMD (PARTNER)
(360) 577-0566
Entity
Organization

Contact information

Practice address
820 OCEAN BEACH HWY,, STE 110, LONGVIEW, WA 98632-4011
(360) 577-0566
(360) 425-6935
Mailing address
820 OCEAN BEACH HWY, STE 110, LONGVIEW, WA 98632-4080
(360) 577-0566
(360) 425-6935

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
DE00008175
WA
1223G0001X
General Practice Dentistry
Primary
DE00009942
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1205926110
NPI- PERSONAL
WA
05
5046164
WA
Enumeration date
03/28/2007
Last updated
03/18/2010
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