Organization
COLE J. JOHNSON DDS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. COLE JEROME JOHNSON DDS (OWNER/PRESIDENT)
(479) 452-2995
Entity
Organization
Contact information
Practice address
2420 S 51ST CT, FORT SMITH, AR 72903-3669
(479) 452-2995
Mailing address
2420 S 51ST CT, FORT SMITH, AR 72903-3669
(479) 452-2995
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3867
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
199375608
—
AR
Enumeration date
12/22/2014
Last updated
12/22/2014
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