Organization
MOUNTAIN VIEW ORAL SURGERY AND DENTAL IMPLANTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARVIN J JOHNSON DMD (ORAL SURGEON / OWNER)
(503) 472-1468
Entity
Organization
Contact information
Practice address
1046 NE 3RD ST, MCMINNVILLE, OR 97128-4418
(503) 472-1468
(503) 434-9214
Mailing address
1046 NE 3RD ST, MCMINNVILLE, OR 97128-4418
(503) 472-1468
(503) 434-9214
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
D5964
OR
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
D9272
OR
Other
Enumeration date
08/02/2010
Last updated
08/02/2010
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