# ALICE J JOHNSON, DDS, PA

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

## Provider details

- **NPI number:** 1164707972
- **Authorized official:** DR. ALICE J JOHNSON DDS (PRESIDENT/OWNER)
- **Authorized official phone:** (512) 452-2195

## Contact information

- **Practice address:** 5802 BERKAMN DR, SUITE B, AUSTIN, TX 78723-2625
- **Practice address phone:** (512) 452-2195
- **Practice address fax:** (512) 452-1871
- **Mailing address:** 5802 BERKAMN DR, SUITE B, AUSTIN, TX 78723-2625
- **Mailing address phone:** (512) 452-2195
- **Mailing address fax:** (512) 452-1871

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | 17654 | TX | Yes |

## Other

- **Enumeration date:** 10/13/2011
- **Last updated:** 10/13/2011