# KRISTA JOHNSON DMD PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Aspen Dental
- **Organization subpart:** No

## Provider details

- **NPI number:** 1598203606
- **Authorized official:** KRISTA JOHNSON DMD (OWNER)
- **Authorized official phone:** (701) 526-4652

## Contact information

- **Practice address:** 1650 45TH ST S STE 108, FARGO, ND 58103-3247
- **Practice address phone:** (701) 526-4652
- **Practice address fax:** (701) 282-2572
- **Mailing address:** PO BOX 3189, SYRACUSE, NY 13220-3189
- **Mailing address phone:** (315) 454-6000
- **Mailing address fax:** (315) 410-5531

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 2272 | ND | Yes |

## Other

- **Enumeration date:** 02/09/2017
- **Last updated:** 02/09/2017