Individual
MS. MELISSA MARY JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
1711 SHAWNO AVE, GREEN BAY, WI 54303
(920) 494-9541
(920) 494-8195
Mailing address
1300 SAN JOSE PLACE, GREEN BAY, WI 54303
(715) 923-4148
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
6901016
WI
Other
Enumeration date
02/22/2007
Last updated
07/08/2007
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