Individual
DR. DALE S. JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1319 VIVIAN ST, LONGMONT, CO 80501-3216
(303) 772-3611
(303) 772-3609
Mailing address
1319 VIVIAN ST, LONGMONT, CO 80501-3216
(303) 772-3611
(303) 772-3609
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
18358
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01183581
—
CO
Enumeration date
05/11/2006
Last updated
06/24/2010
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