Individual
DR. M. ANDREW JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
41 E 400 N, #338, LOGAN, UT 84321-4020
(435) 752-2153
Mailing address
41 E 400 N, #338, LOGAN, UT 84321-4020
(435) 752-2153
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
14633-9921
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14633-9921
STATE LICENSE
UT
Enumeration date
08/15/2008
Last updated
08/15/2008
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