Individual
DR. RUSTY JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
429 N DUVAL ST, CLAXTON, GA 30417-5939
(912) 732-1011
Mailing address
192 ADDIE RD, GRANITEVILLE, SC 29829-3732
(803) 646-4130
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN123777
GA
Other
Enumeration date
06/30/2025
Last updated
06/30/2025
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