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Organization

JOHNSON FAMILY DENTAL, LLC

Active
Other names
Johnson and Johnson Family Dentistry
Organization subpart
No

Provider details

NPI number
Authorized official
RYAN D JOHNSON D.M.D. (DENTIST)
(217) 787-7744
Entity
Organization

Contact information

Practice address
2525 W ILES AVE, SPRINGFIELD, IL 62704-4283
(217) 787-7744
Mailing address
2525 W ILES AVE, SPRINGFIELD, IL 62704-4283
(217) 787-7744

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019028015
IL

Other

Enumeration date
12/12/2012
Last updated
12/12/2012
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