Individual
MRS. REBECCA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
2906 EVERGREEN DR, BEDFORD, IN 47421-5288
(812) 279-6455
(812) 279-0130
Mailing address
2906 EVERGREEN DR, BEDFORD, IN 47421-5288
(812) 279-6455
(812) 279-0130
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
13005334A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13005334A
REGISTERED DENTAL HYGIENE
IN
Enumeration date
01/08/2007
Last updated
07/08/2007
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