| NPI | 1982706677 |
|---|---|
| Other Name | JOHNSON CREEK DENTAL CARE |
| Entity Type | Organization |
| Authorized Contact | TIMOTHY PATRICK SHANNON President 503-654-7773 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OR D6975) |
| Enumeration Date | 2006-09-02 |
| Last Update Date | 2020-08-22 |