Individual
KIRK H. JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
100 N ACADEMY AVE, DANVILLE, PA 17822-3312
(570) 271-6355
(570) 271-5788
Mailing address
100 N ACADEMY AVE, DANVILLE, PA 17822-4903
(570) 271-6144
(570) 271-6578
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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