Organization
SANDPOINT DENTAL COSMETICS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSEPH JOHNSON DMD (DOCTOR)
(208) 255-1255
Entity
Organization
Contact information
Practice address
30336 HIGHWAY 200, SUITE A, PONDERAY, ID 83852-9775
(208) 255-1255
(208) 263-0490
Mailing address
30336 HIGHWAY 200, SUITE A, PONDERAY, ID 83852-9775
(208) 255-1255
(208) 263-0490
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D4103
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1831385590
NPI TYPE ONE
ID
Enumeration date
05/20/2010
Last updated
02/21/2013
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