Individual
KIRK H. JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
5151071-9923
UT
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DA031698
PA
Other
Enumeration date
05/03/2007
Last updated
08/17/2020
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