Individual
DR. MARK A JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1714 W HUNT HWY STE 100, QUEEN CREEK, AZ 85143-5245
(480) 882-3119
Mailing address
1714 W HUNT HWY STE 100, QUEEN CREEK, AZ 85143-5245
(480) 882-3119
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D008712
AZ
Other
Enumeration date
06/05/2013
Last updated
08/12/2014
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