Individual
DR. RANDALL DAVID JOHSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2355 ARIEL ST N, MAPLEWOOD, MN 55104
(651) 770-0428
(651) 770-3362
Mailing address
2355 ARIEL ST N, MAPLEWOOD, MN 55104
(651) 770-0428
(651) 770-3362
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
8212
MN
Other
Enumeration date
09/15/2006
Last updated
07/08/2007
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