# DRS EBENEZER & RACHEL JOHNSON DDS INC

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

## Provider details

- **NPI number:** 1578730628
- **Authorized official:** DR. RACHEL R JOHNSON DDS (CFO)
- **Authorized official phone:** (909) 621-6002

## Contact information

- **Practice address:** 511 S RIVERSIDE AVE, RIALTO, CA 92376
- **Practice address phone:** (909) 820-2274
- **Practice address fax:** (909) 820-2280
- **Mailing address:** 9645 MONTE VISTA AVE, SUITE 305, MONTCLAIR, CA 91763
- **Mailing address phone:** (909) 621-6002
- **Mailing address fax:** (909) 621-6634

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | D36088 | CA | Yes |
| 122300000X | Dentist | D37238 | CA | — |

## Other

- **Enumeration date:** 05/08/2008
- **Last updated:** 05/08/2008