Organization
DRS JOHNSON TERRY & ASSOCIATES
Active
Other names
Family Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
LINDA L VANVOLKENBURGH (SYSTEM MANAGER)
(812) 689-7461
Entity
Organization
Contact information
Practice address
301 GASLIGHT DR, VERSAILLES, IN 47042-7322
(812) 689-6522
Mailing address
301 GASLIGHT DR, VERSAILLES, IN 47042-7322
(812) 689-6522
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12008101
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200218610A
—
IN
Enumeration date
05/02/2008
Last updated
05/02/2008
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