Organization
ANDREW D JOHNSON DDS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREW JOHNSON DDS (OWNER/DENTIST)
(316) 838-1300
Entity
Organization
Contact information
Practice address
2203 N SWEETBRIAR ST, WICHITA, KS 67204-5518
(316) 838-1300
Mailing address
2203 N SWEETBRIAR ST, WICHITA, KS 67204-5518
(316) 838-1300
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
61357
KANSAS DENTAL BOARD
KS
Enumeration date
10/20/2020
Last updated
10/20/2020
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