| NPI | 1184154155 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT JOHNSON Office Manager 360-794-8580 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA D00009214) |
| Enumeration Date | 2017-06-13 |
| Last Update Date | 2022-07-21 |