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Organization
JOHNSON PERIODONTICS, PROF. LLC
Active
Organization
JOHNSON PERIODONTICS, PROF. LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAUL JOHNSON DDS (MANAGER)
(605) 335-8830
Entity
Organization
Contact information
Practice address
3805 S KIWANIS CIR, SIOUX FALLS, SD 57105-4266
(605) 335-8830
Mailing address
3805 S KIWANIS CIR, SIOUX FALLS, SD 57105-4266
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
—
—
Other
Enumeration date
01/02/2018
Last updated
06/11/2019
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