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Organization
GARY R. JOHNSON, D.D.S., P.C.
Active
Organization
GARY R. JOHNSON, D.D.S., P.C.
Active
Other names
Berkeley Dental Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GARY ROBERT JOHNSON D.D.S. (PRESIDENT)
(708) 544-7474
Entity
Organization
Contact information
Practice address
5646 SAINT CHARLES RD, SUITE C, BERKELEY, IL 60163-1148
(708) 544-7474
Mailing address
5646 SAINT CHARLES RD, SUITE C, BERKELEY, IL 60163-1148
(708) 544-7474
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
07/27/2006
Last updated
10/26/2015
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