Individual
JODI BROOKE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
9775 SAINT CHARLES ROCK RD, SAINT LOUIS, MO 63114-2635
(314) 427-7400
Mailing address
9775 SAINT CHARLES ROCK RD, SAINT LOUIS, MO 63114-2635
(314) 427-7400
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2005017506
MO
Other
Enumeration date
08/14/2006
Last updated
02/18/2014
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