Individual
MR. NICHOLAS CRAIG JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
50 N CENTER ST, EAST ALTON, IL 62024-1708
(618) 259-5563
Mailing address
5753 ITASKA ST, SAINT LOUIS, MO 63109-2835
(314) 766-2724
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
IL
Other
Enumeration date
08/17/2006
Last updated
08/10/2007
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