Individual
MR. KENTON M JOHNSON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DDS MS
Contact information
Practice address
2690 SIVELLING AVE N, STE 250, ROSEVILLE, MN 55113
(651) 633-1834
(651) 633-0995
Mailing address
PO BOX 23029, RICHFIELD, MN 55423
(612) 861-9123
(612) 861-9155
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D10828
MN
Other
Enumeration date
04/27/2006
Last updated
07/08/2007
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