Individual
JILL A JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDH, LAP
Contact information
Practice address
1600 LOST CREEK RD, ANACONDA, MT 59711-9621
(817) 368-9421
Mailing address
1600 LOST CREEK RD, ANACONDA, MT 59711-9621
(817) 368-9421
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
DEN-RDH-LIC-1280
MT
Other
Enumeration date
04/10/2015
Last updated
08/13/2015
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