# CRYSTAL SMILES PC

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

## Provider details

- **NPI number:** 1700075041
- **Authorized official:** DR. CRYSTAL L. JOHNSON DDS (DOCTOR/OWNER)
- **Authorized official phone:** (803) 256-2333

## Contact information

- **Practice address:** 1412 BARNWELL ST, COLUMBIA, SC 29201-3512
- **Practice address phone:** (803) 256-2333
- **Practice address fax:** (803) 256-1580
- **Mailing address:** 1412 BARNWELL ST, COLUMBIA, SC 29201-3512
- **Mailing address phone:** (803) 256-2333
- **Mailing address fax:** (803) 256-1580

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | SC | Yes |

## Other

- **Enumeration date:** 10/23/2007
- **Last updated:** 07/21/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | ZA9587 | — | SC |