Organization
AN-LOUISE JOHNSON DMD MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AN-LOUISE JOHNSON DMD MD (PRESIDENT)
(781) 545-6565
Entity
Organization
Contact information
Practice address
56 NEW DRIFTWAY, SUITE 309, SCITUATE, MA 02066-4533
(781) 545-6565
(781) 545-6597
Mailing address
PO BOX 363, SCITUATE, MA 02066-0363
(781) 545-6565
(781) 545-6597
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
20760
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00020760
DELTA DENTAL OF MA
MA
01
—
11477985
AETNA MEDICAL
—
01
—
494138
TUFTS HEALTH CARE
MA
01
—
98018
FALON HEALTH CARE
MA
01
—
AA37401
HARVARD PILGRIM
—
01
—
X12124
BCBS MEDICAL AND DENTAL
—
Enumeration date
09/21/2006
Last updated
10/19/2007
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