Organization
NORTH STAR CHILDREN'S DENTISTRY, PC
Active
Other names
Gregory L. Johnson, DDS, PC
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY L. JOHNSON D.D.S. (PRESIDENT)
(907) 452-4509
Entity
Organization
Contact information
Practice address
114 MINNIE ST, SUITE A, FAIRBANKS, AK 99701-3006
(907) 452-4509
(907) 457-4509
Mailing address
114 MINNIE ST, SUITE A, FAIRBANKS, AK 99701-3006
(907) 452-4509
(907) 457-4509
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DD0657
—
AK
05
—
DD55881
—
AK
Enumeration date
12/05/2006
Last updated
05/08/2009
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