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Organization
WICHITA SMILES
Active
Organization
WICHITA SMILES
Active
Other names
Smart Mouth Family Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFREY BULLOCK JOHNSON DDS (DENTIST)
(940) 761-5979
Entity
Organization
Contact information
Practice address
2120 VIRGINIA DR STE A, WICHITA FALLS, TX 76309-4646
(940) 761-5979
(903) 465-1134
Mailing address
2120 VIRGINIA DR STE A, WICHITA FALLS, TX 76309-4646
(940) 761-5979
(903) 465-1134
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
30183
TX
Other
Enumeration date
04/28/2015
Last updated
04/28/2015
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