Individual
DR. MARK STEVEN JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
93 OAK AVENUE, 3, ANNANDALE, MN 55302-0539
(320) 274-2475
(320) 274-3152
Mailing address
93 OAK AVENUE SOUTH, PO BOX 539, ANNANDALE, MN 55302-0539
(320) 274-2475
(320) 274-3152
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
9649
MN
Other
Enumeration date
01/08/2007
Last updated
07/08/2007
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