# DONALD J JOHNSON DDS INC

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

## Provider details

- **NPI number:** 1205120441
- **Authorized official:** DONALD J JOHNSON DDS (OWNER)
- **Authorized official phone:** (208) 667-4551

## Contact information

- **Practice address:** 114 W NEIDER AVE, COEUR D'ALENE, ID 83815-9300
- **Practice address phone:** (208) 667-4551
- **Practice address fax:** (866) 683-6479
- **Mailing address:** 114 W NEIDER AVE, COEUR D'ALENE, ID 83815-9300
- **Mailing address phone:** (208) 667-4551

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | D1677 | ID | Yes |

## Other

- **Enumeration date:** 06/06/2011
- **Last updated:** 06/22/2018