Individual
DR. LYNN MICHAEL JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2050 2ND ST SE, KIRTLAND AFB, NM 87117-5524
(505) 846-2466
Mailing address
11217 WOODMAR LN NE, ALBUQUERQUE, NM 87111-6510
(505) 291-1437
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
105419
CO
Other
Enumeration date
04/03/2006
Last updated
11/20/2007
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