Organization
IMAGINE KIDS DENTISTRY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER JOHNSON DDS (OWNER/PEDIATRIC DENTIST)
(719) 722-4999
Entity
Organization
Contact information
Practice address
6620 CAMDEN BLVD, FOUNTAIN, CO 80817-2505
(719) 722-4999
Mailing address
5467 PADDINGTON CREEK PL, COLORADO SPRINGS, CO 80924-2083
(719) 722-4999
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
261QD0000X
Dental Clinic/Center
—
—
Other
Enumeration date
12/10/2019
Last updated
02/12/2020
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