Individual
DR. KAREN EVANGELINE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS, MHS
Contact information
Practice address
2757 LAUREL ST STE 1, COLUMBIA, SC 29204-2037
(803) 606-9011
(803) 630-1529
Mailing address
PO BOX 25731, COLUMBIA, SC 29224-5731
(803) 606-9011
(803) 630-1529
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
11759
MD
1223P0300X
Periodontics
Primary
3116/PERIO 470
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Z31163
—
SC
Enumeration date
06/02/2005
Last updated
10/10/2023
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