Individual
OWEN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1048 UNION ST, BANGOR, ME 04401-3016
(207) 945-5247
Mailing address
PO BOX 1599, BANGOR, ME 04402-1599
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DEN4382
ME
Other
Enumeration date
05/28/2014
Last updated
05/28/2014
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