Individual
MALEA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH, EPDH
Contact information
Practice address
485 YAMPA AVE, CRAIG, CO 81625-2609
(970) 824-8000
Mailing address
485 YAMPA AVE, CRAIG, CO 81625-2609
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
DH.002024069
CO
124Q00000X
Dental Hygienist
H6844
OR
Other
Enumeration date
10/26/2015
Last updated
10/26/2015
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