| NPI | 1891554705 |
|---|---|
| Doing Business As | JOHANSEN DENTAL |
| Entity Type | Organization |
| Authorized Contact | MARK CHRISTENSEN Credentialing Specialist 801-305-3460 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2024-03-14 |
| Last Update Date | 2024-03-14 |