Individual
ROSE MARGARETTE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DENTAL HYGIENIST
Contact information
Practice address
24065 BIGGAR LANE, COVELO, CA 95428-9542
(707) 983-6181
(707) 983-6802
Mailing address
1373 CARTER WAY, REDDING, CA 96002-0337
(530) 215-6341
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
22605
CA
124Q00000X
Dental Hygienist
22605688
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
942151392
—
CA
Enumeration date
01/22/2020
Last updated
01/22/2020
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