Individual
DR. BRYAN JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S., M.S.
Contact information
Practice address
19255 SW 65TH AVE, SUITE #230, TUALATIN, OR 97062-7451
(503) 691-9970
Mailing address
19255 SW 65TH AVE, SUITE #230, TUALATIN, OR 97062-7451
(503) 691-9970
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
D7481
OR
Other
Enumeration date
05/10/2007
Last updated
07/08/2007
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