Organization
LARRY A JOHNSON DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LARRY A JOHNSON DDS (PERIODENTIST)
(508) 347-2673
Entity
Organization
Contact information
Practice address
69 HALL ROAD, STURBRIDGE, MA 01566
(508) 347-2673
(508) 347-5085
Mailing address
69 HALL ROAD, STURBRIDGE, MA 01566
(508) 347-2673
(508) 347-5085
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
12356
MA
Other
Enumeration date
10/11/2006
Last updated
08/22/2020
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