Individual
DR. CORY MICHAEL JOHNSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1215 NE 7TH ST, SUITE A, GRANTS PASS, OR 97526-1450
(541) 479-6623
Mailing address
1215 NE 7TH ST, SUITE A, GRANTS PASS, OR 97526-1450
(541) 479-6623
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
9969
OR
1223G0001X
General Practice Dentistry
DEN-10208
CO
Other
Enumeration date
06/04/2010
Last updated
01/02/2015
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