# DR. MARK W. JOHNSON, PA

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

## Provider details

- **NPI number:** 1568531861
- **Authorized official:** DR. MARK WINTON JOHNSON D.M.D., M.S. (VICE PRESIDENT)
- **Authorized official phone:** (252) 638-6177

## Contact information

- **Practice address:** 604 MCCARTHY BLVD, NEW BERN, NC 28562-5231
- **Practice address phone:** (252) 638-6177
- **Practice address fax:** (252) 638-5269
- **Mailing address:** 604 MCCARTHY BLVD, NEW BERN, NC 28562-5231
- **Mailing address phone:** (252) 638-6177
- **Mailing address fax:** (252) 638-5269

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | NC | Yes |

## Other

- **Enumeration date:** 11/08/2006
- **Last updated:** 09/09/2020