Individual
DR. MARK JOSEPH JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
98 W 66TH ST, RICHFIELD, MN 55423-2511
(612) 866-1005
(612) 866-7805
Mailing address
657 WESLEY LN, MENDOTA HEIGHTS, MN 55118-4347
(651) 454-2104
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
9038
MN
Other
Enumeration date
01/16/2007
Last updated
07/08/2007
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