Individual
DR. BRADLEY R JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D., M.S.D.
Contact information
Practice address
7288 MENTOR AVE, MENTOR, OH 44060-7578
(440) 946-0088
(757) 314-7942
Mailing address
577 STERNBERG AVE, HQ US ARMY DENTAL ACTIVITY, FORT EUSTIS, VA 23604-1526
(757) 314-7944
(757) 314-7942
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401413320
VA
Other
Enumeration date
08/25/2011
Last updated
12/16/2020
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