Organization
OJH CLINIC NO 3 INC - MONROE FAMILY DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. OTTO J HANSSEN DDS (OWNER DENTIST)
(253) 630-4081
Entity
Organization
Contact information
Practice address
19071 HWY 2, MONROE, WA 98272
(360) 794-8000
(360) 794-6257
Mailing address
19071 HWY 2, MONROE, WA 98272
(360) 794-8000
(360) 794-6257
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5262
WA
Other
Enumeration date
10/06/2006
Last updated
08/22/2020
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