Individual
DR. ERICA L JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
2525 W ILES, SPRINGFIELD, IL 62704
(217) 787-7744
Mailing address
2525 W ILES AVE, SPRINGFIELD, IL 62704-4283
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019028033
IL
Other
Enumeration date
07/17/2009
Last updated
11/29/2012
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