Individual
TAYLOR JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10155 UNIVERSITY AVE NE STE 112, BLAINE, MN 55434-8058
(763) 784-1242
Mailing address
6801 PAIUTE DR, EDINA, MN 55439-1032
(952) 826-9758
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D14245
MN
Other
Enumeration date
07/22/2019
Last updated
07/22/2019
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