# JOHNSON DENTISTRY CENTER, P.A.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Johnson Dentistry
- **Organization subpart:** No

## Provider details

- **NPI number:** 1578771408
- **Authorized official:** DR. JOHN ALBERT JOHNSON JR. D.D.S. (PRESIDENT)
- **Authorized official phone:** (979) 774-7500

## Contact information

- **Practice address:** 3702 COPPERCREST DRIVE, BRYAN, TX 77802
- **Practice address phone:** (979) 774-7500
- **Practice address fax:** (979) 774-7071
- **Mailing address:** 2752 ROCKCLIFFE LOOP, COLLEGE STATION, TX 77845

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 21064 | TX | Yes |

## Other

- **Enumeration date:** 05/21/2007
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | $$$$$$$$$ | SOCIAL SECURITY \# | — |
| 01 | — | 21064 | STATE LICENSE | TX |