Individual
KIA SHERETTE MARLEY JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
1901 WESTRIDGE RD STE 102, GREENSBORO, NC 27410-2425
(336) 517-1132
Mailing address
2101 PETERS CREEK PKWY STE 16-19, WINSTON SALEM, NC 27127-3726
(336) 293-8728
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
10350
NC
Other
Enumeration date
02/15/2016
Last updated
09/08/2023
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