Individual
MR. TIMOTHY MARK JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
3715 BRIDGE ST, ST FRANCIS, MN 55070
(763) 753-1900
(763) 753-4220
Mailing address
PO BOX 156, ST FRANCIS, MN 55070
(763) 753-1900
(763) 753-4220
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
8574
MN
Other
Enumeration date
12/05/2006
Last updated
07/08/2007
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