Individual
DR. MATTHEW JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
110 S 59TH ST, SPRINGFIELD, OR 97478-6975
(541) 747-8030
Mailing address
110 S 59TH ST, SPRINGFIELD, OR 97478-6975
(541) 747-8030
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
61523
CA
122300000X
Dentist
D10204
OR
Other
Enumeration date
09/28/2012
Last updated
08/26/2015
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