Organization
H A JOHNSON DDS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HENDERSON ANDREW JOHNSON IV D.D.S. (PRESIDENT-OWNER)
(216) 566-7770
Entity
Organization
Contact information
Practice address
2475 E 22ND ST, SUITE 204, CLEVELAND, OH 44115-3221
(216) 566-7770
(216) 566-7704
Mailing address
2475 E 22ND ST, SUITE 204, CLEVELAND, OH 44115-3221
(216) 566-7770
(216) 566-7704
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
30-017934
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0668406
—
OH
Enumeration date
05/23/2007
Last updated
08/22/2020
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