Individual
DR. MARY SMOAK JOHNSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
225 S PLEASANTBURG DR, SUITE E10, GREENVILLE, SC 29607-2544
(864) 233-7737
(864) 233-6559
Mailing address
201 W 8TH ST, SUITE 810, PUEBLO, CO 81003-3038
(719) 562-4447
(719) 583-1801
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2365
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZX2365
—
SC
Enumeration date
11/16/2010
Last updated
05/21/2012
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