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Individual

DR. OWEN W. JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
203 PARK AVE, PINE RIVER, MN 56474
(218) 587-4437
(218) 587-4479
Mailing address
P.O. BOX 71, PINE RIVER, MN 56474
(218) 587-4437
(218) 587-4479

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
8358
MN

Other

Enumeration date
10/03/2006
Last updated
07/08/2007
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