Individual
DR. JACOB ADAM JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
3050 SYCAMORE SCHOOL RD, FORT WORTH, TX 76133
(817) 370-0021
Mailing address
2101 BRADLEY DR, KELLER, TX 76248-6868
(480) 207-9709
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
34630
TX
1223P0221X
Pediatric Dentistry
D7748
AZ
Other
Enumeration date
09/16/2008
Last updated
07/20/2019
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