Individual
GRANT D. JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S., M.S.
Contact information
Practice address
2121 CENTRAL DR, SUITE 2, BEDFORD, TX 76021-5884
(817) 283-3777
(817) 283-6929
Mailing address
2121 CENTRAL DR, SUITE 2, BEDFORD, TX 76021-5884
(817) 283-3777
(817) 283-6929
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
18831
TX
Other
Enumeration date
12/21/2011
Last updated
12/21/2011
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