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Organization
PAUL W. JOHNSON,PH.D., D.M.D., INC.
Active
Organization
PAUL W. JOHNSON,PH.D., D.M.D., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAUL WILLIAM JOHNSON PH.D., D.M.D. (PRESIDENT)
(916) 691-6442
Entity
Organization
Contact information
Practice address
8007 LAGUNA BLVD, SUITE 1, ELK GROVE, CA 95758-7920
(916) 691-6442
(916) 691-6452
Mailing address
8007 LAGUNA BLVD, SUITE 1, ELK GROVE, CA 95758-7920
(916) 691-6442
(916) 691-6452
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
43798
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
45854197
STATE EMPLOYER ID
CA
01
—
680448471
INDIVIDUAL EMPLOYER ID
CA
Enumeration date
11/13/2006
Last updated
05/21/2008
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