Individual
DR. JEFFERY JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1 SOUTHTOWNE DR, POTOSI, MO 63664-5729
(573) 438-8401
Mailing address
5901 COLONY CHURCH RD, FARMINGTON, MO 63640-7424
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2016017399
MO
Other
Enumeration date
06/01/2016
Last updated
06/01/2016
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