Individual
CHRISTOPHER M JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
425 2ND ST, EXCELSIOR, MN 55331-2038
(952) 474-6133
(952) 474-7361
Mailing address
10511 E RIVERVIEW DR, EDEN PRAIRIE, MN 55347-4918
(952) 941-9007
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D11061
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020998800
MN CARE ID
MN
Enumeration date
10/20/2005
Last updated
11/11/2010
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