Individual
DR. DEREK LYLE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
175 BRINKBY AVE, RENO, NV 89509-4327
(775) 825-9225
Mailing address
175 BRINKBY AVE, RENO, NV 89509-4327
(775) 825-9225
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6090
NV
Other
Enumeration date
06/03/2011
Last updated
06/03/2011
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