# BRAD S. JOHNSON, DMD, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1144667908
- **Authorized official:** MRS. JANICE D HURST (PRACTICE MANAGER)
- **Authorized official phone:** (423) 587-8383

## Contact information

- **Practice address:** 703 K ST, GREENEVILLE, TN 37745-6246
- **Practice address phone:** (423) 639-6769
- **Mailing address:** 703 K ST, GREENEVILLE, TN 37745-6246
- **Mailing address phone:** (423) 639-6769

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | DS8950 | TN | Yes |

## Other

- **Enumeration date:** 06/03/2013
- **Last updated:** 06/03/2013