Individual
DR. COREY IVAN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
2425 GRAND AVE, STE 109, GLENWOOD SPRINGS, CO 81601-4180
(970) 945-9119
(970) 945-1065
Mailing address
2425 GRAND AVE, STE 109, GLENWOOD SPRINGS, CO 81601-4180
(970) 945-9119
(970) 945-1065
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7486
CO
Other
Enumeration date
10/10/2006
Last updated
07/08/2007
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