Individual
MICHELLE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
4135 WILSON AVE SW, CEDAR RAPIDS, IA 52404-6342
(319) 396-0700
Mailing address
4135 WILSON AVE SW, CEDAR RAPIDS, IA 52404-6342
(319) 396-0700
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
08964
IA
Other
Enumeration date
09/03/2012
Last updated
09/03/2012
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