Individual
MARK STEVEN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
6601 LYNDALE AVE S, SUITE 220, RICHFIELD, MN 55423-2477
(612) 861-9109
Mailing address
4521 HERITAGE HILLS CIR, BLOOMINGTON, MN 55437-2856
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
9555
MN
Other
Enumeration date
08/12/2006
Last updated
07/08/2007
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