Individual
DR. RICHARD MATHIAS JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1507 TOWER AVE, RM 427, SUPERIOR, WI 54880
(715) 394-5792
Mailing address
1507 TOWER AVE, RM 427, SUPERIOR, WI 54880
(715) 394-5792
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5000864015
WI
122300000X
Dentist
D7559
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33674700
—
WI
01
—
90951JO
BCBS
—
Enumeration date
06/15/2006
Last updated
07/13/2026
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