Individual
DR. JEFFREY S JOHANNESMEYER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
6637 W PEORIA AVE STE D2, GLENDALE, AZ 85302-7023
(623) 300-2550
Mailing address
4954 W JEREMY DR, GLENDALE, AZ 85308-1405
(520) 401-4450
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D010710
AZ
Other
Enumeration date
06/24/2019
Last updated
06/09/2021
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