Individual
MILES TYLER JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
7278 HIGHWAY 72 W, MADISON, AL 35758-9551
(256) 217-7815
Mailing address
703 CONTINENTAL DR, MADISON, AL 35758-4803
(404) 641-1218
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D.007232-C1
AL
Other
Enumeration date
07/17/2023
Last updated
07/17/2023
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