Organization
PETER F JOHNSON DMD A PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PETER FINK JOHNSON D.M.D. (PRESIDENT)
(619) 463-3737
Entity
Organization
Contact information
Practice address
5565 GROSSMONT CENTER DR, SUITE 110-1, LA MESA, CA 91942-3020
(619) 463-3737
(619) 463-3730
Mailing address
5565 GROSSMONT CENTER DR, SUITE 110-1, LA MESA, CA 91942-3020
(619) 463-3737
(619) 463-3730
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
D25550
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D25550
PTAN
CA
Enumeration date
04/20/2010
Last updated
06/22/2010
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