Individual
RICHARD S JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
SOUTH VALLEY FAMILY DENTAL DR. RICHARD S. JOHNSON DDS, 271 N. SPRINGCREEK PKWY SUITE D, PROVIDENCE, UT 84332-9875
(435) 787-2122
(435) 755-6797
Mailing address
SOUTH VALLEY FAMILY DENTAL DR. RICHARD S. JOHNSON DDS, 271 N. SPRINGCREEK PKWY SUITE D, PROVIDENCE, UT 84332-9875
(435) 787-2122
(435) 755-6797
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5909098
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
202830421
TAX I.D. #
UT
01
—
5909098
STATE OF UTAH LICENSE
UT
Enumeration date
07/31/2006
Last updated
03/07/2023
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