Individual
DR. CALEB JOHNSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
303 S OSAGE AVE, TIPTON, MO 65081-8470
(660) 433-5741
Mailing address
3816 NW 75TH ST, KANSAS CITY, MO 64151-4247
(816) 541-1897
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2019014269
MO
Other
Enumeration date
09/26/2014
Last updated
12/18/2019
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