Organization
MALRIE E. JOHNSON DDS. PA.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MALRIE EMMITT JOHNSON DDS (PRES/CEO)
(336) 427-8544
Entity
Organization
Contact information
Practice address
603 AYERSVILLE RD., MAYODAN, NC 27027
(336) 427-8544
Mailing address
603 AYERSVILLE RD., MAYODAN, NC 27027
(336) 427-8544
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
5024
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8994643
—
NC
Enumeration date
02/22/2008
Last updated
02/22/2008
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