Organization
JOHNSON ORTHODONTICS
Active
Other names
Imagine Braces
Organization subpart
No
Provider details
NPI number
Authorized official
WARREN JOHNSON DDS (PRESIDENT)
(719) 432-9807
Entity
Organization
Contact information
Practice address
6620 CAMDEN BLVD, FOUNTAIN, CO 80817-2505
(719) 631-6649
Mailing address
5850 TUTT CENTER PT STE 100, COLORADO SPRINGS, CO 80922-3520
(719) 596-3081
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1223X0400X
—
CO
Enumeration date
03/10/2020
Last updated
08/05/2022
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