Individual
MICHELE DAWN JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDHAP
Contact information
Practice address
520 GREENWOOD AVE., BLUE LAKE, CA 95525-0903
(707) 668-5683
(707) 845-0088
Mailing address
PO BOX 903, 520 GREENWOOD AVE., BLUE LAKE, CA 95525-0903
(707) 668-5683
(707) 845-0088
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
654
CA
Other
Enumeration date
04/18/2017
Last updated
04/18/2017
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