Individual
DR. JAMES FREDERICK JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
512 NE 1ST AVE, GRAND RAPIDS, MN 55744-2610
(218) 326-2531
Mailing address
512 NE 1ST AVE, GRAND RAPIDS, MN 55744-2610
(218) 326-2531
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
9072
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
71484JO
BLUE CROSS BLUE SHIELD MN
MN
Enumeration date
09/15/2006
Last updated
07/08/2007
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