Organization
CORRIDOR FAMILY DENTISTRY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRAD JOHNSON DDS (DENTIST)
(319) 331-8113
Entity
Organization
Contact information
Practice address
1055 N CENTER POINT RD, HIAWATHA, IA 52233-1231
(319) 366-8521
Mailing address
2375 12TH ST, CORALVILLE, IA 52241-3118
(319) 331-8113
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
08574
IA
Other
Enumeration date
02/11/2010
Last updated
02/11/2010
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