Individual
DR. DERRICK V JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
114 DYER STREET, MOUNTAIN HOME, AR 72653
(870) 580-0950
(870) 580-0951
Mailing address
114 DYER STREET, MOUNTAIN HOME, AR 72653
(870) 580-0950
(870) 580-0951
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
4583
AZ
122300000X
Dentist
Primary
AR3739
AR
Other
Enumeration date
08/24/2006
Last updated
06/09/2015
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