Individual
DR. TODD A JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
5702 MEMORIAL CT, WESTON, WI 54476-6502
(715) 496-1128
(715) 972-8123
Mailing address
5702 MEMORIAL CT, WESTON, WI 54476-6502
(715) 496-1128
(715) 972-8123
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
019025511
IL
1223G0001X
General Practice Dentistry
Primary
1001483
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1004971
—
IL
Enumeration date
12/07/2006
Last updated
04/14/2017
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