Individual
DR. MIMI V. JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
235 MANNHEIM RD, BELLWOOD, IL 60104-1339
(708) 544-5656
Mailing address
235 MANNHEIM RD, PO BOX 239, BELLWOOD, IL 60104-1339
(708) 544-5656
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
IL
Other
Enumeration date
04/12/2007
Last updated
07/08/2007
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