Whalio Doctors

NPI 1346417748

Mack S Johnsen DMD PC

Organisation General Practice Dentistry Wilsonville, OR

Practice location

Address
29990 SW Town Center LP Suite a, Wilsonville, OR 97070
Phone
(503) 682-2110
Mailing address
29990 SW Town Center LP W Suite a, Wilsonville, OR 97070

Authorised official

Name
Mack S Johnsen
Title
Dentist
Phone
(503) 682-2110

Registered specialties

General Practice Dentistry Primary
Dental Providers Taxonomy 1223G0001X Licence 4949 (OR)

Registry record

NPI
1346417748
Entity type
Organization
NPI issued
14 May 2008
Record last updated
14 May 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.