Individual
MR. KEITH DAVID JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
26 S VILLAGE DR, LIBERTY, MO 64068
(816) 781-7571
(816) 781-7933
Mailing address
7912 NW BARR LANE, KC, MO 64152
(816) 746-6246
(816) 781-7933
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
014182
MO
Other
Enumeration date
08/08/2007
Last updated
08/08/2007
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