Individual
DR. EVAN MITCHELL JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD, MS
Contact information
Practice address
3231 ELECTRIC RD, ROANOKE, VA 24018-6425
(540) 989-5621
Mailing address
3231 ELECTRIC RD, ROANOKE, VA 24018-6425
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
0401413850
VA
Other
Enumeration date
05/21/2013
Last updated
05/21/2013
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