| Mark D. Johnson D.D.S., P.S. | |
|
6927 Lakewood Dr W Ste C2 Tacoma WA 98467-3247 | |
| (253) 565-1695 | |
| (253) 565-1588 |
| Full Name | Mark D. Johnson D.D.S., P.S. |
|---|---|
| Speciality | Dentist |
| Location | 6927 Lakewood Dr W Ste C2, Tacoma, Washington |
| Authorized Official Name and Position | Mark Douglas Johnson (DENTIST) |
| Authorized Official Contact | 2535651695 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mark D. Johnson D.D.S., P.S. 6927 Lakewood Dr W Ste C2 Tacoma WA 98467-3247 Ph: (253) 565-1695 | Mark D. Johnson D.D.S., P.S. 6927 Lakewood Dr W Ste C2 Tacoma WA 98467-3247 Ph: (253) 565-1695 |
| NPI Number | 1801022934 |
|---|---|
| Provider Enumeration Date | 06/03/2009 |
| Last Update Date | 06/03/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801022934 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DE60096175 (Washington) | Secondary |
| 122300000X | Dentist | DE00005841 (Washington) | Primary |
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