Individual
DR. JUSTIN LEE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
3551 AMAZONAS DR, JEFFERSON CITY, MO 65109-5717
(573) 634-2400
Mailing address
3551 AMAZONAS DR, JEFFERSON CITY, MO 65109-5717
(573) 634-2400
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2007016529
MO
Other
Enumeration date
06/15/2007
Last updated
04/28/2014
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