Organization
ORVIS J. R. JOHNSON DDS,SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ORVIS JOHNSON DDS (DENTIST)
(920) 923-0310
Entity
Organization
Contact information
Practice address
825 PROSPECT AVE, NORTH FOND DU LAC, WI 54937-1365
(920) 923-0310
(920) 923-5335
Mailing address
825 PROSPECT AVE, NORTH FOND DU LAC, WI 54937-1365
(920) 923-0310
(920) 923-5335
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
5000785-015
WI
Other
Enumeration date
09/25/2006
Last updated
08/22/2020
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