Individual
DR. ANDREW JOHANSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
4970 S 900 E STE B, HOLLADAY, UT 84117-5798
(801) 261-2013
Mailing address
4970 S 900 E STE B, HOLLADAY, UT 84117-5798
(801) 261-2013
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12317484-9923
UT
Other
Enumeration date
05/24/2021
Last updated
05/24/2021
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