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Organization
JESSICA M JOHNSON DDS PA
Active
Organization
JESSICA M JOHNSON DDS PA
Active
Other names
Ottawa Kansas Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JESSICA MARIE JOHNSON DDS (PRESIDENT)
(785) 766-1031
Entity
Organization
Contact information
Practice address
1334 S MAIN ST, OTTAWA, KS 66067-3527
(785) 242-5753
Mailing address
1334 S MAIN ST, OTTAWA, KS 66067-3527
(785) 242-5753
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
61001
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
61001
LICENSE NUMBER
KS
Enumeration date
07/04/2017
Last updated
07/21/2022
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