Organization
GARY R. JOHNSON, D.D.S., P.C.
Active
Other names
Berkeley Dental Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GARY ROBERT JOHNSON D.D.S. (PRESIDENT)
(708) 544-7474
Entity
Organization
Contact information
Practice address
5646 SAINT CHARLES RD, SUITE C, BERKELEY, IL 60163-1148
(708) 544-7474
Mailing address
5646 SAINT CHARLES RD, SUITE C, BERKELEY, IL 60163-1148
(708) 544-7474
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
07/27/2006
Last updated
10/26/2015
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