Individual
DR. GREGORY LEE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S
Contact information
Practice address
114 MINNIE ST, SUITE E, FAIRBANKS, AK 99701-3006
(907) 388-3252
Mailing address
114 MINNIE ST, SUITE E, FAIRBANKS, AK 99701-3006
(907) 388-3252
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
2954
WI
1223P0221X
Pediatric Dentistry
Primary
657
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DD0657
—
AK
Enumeration date
06/28/2006
Last updated
02/05/2022
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