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Organization

MICHAEL D. JOHNSON, D.D.S.,P.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MICHAEL DAVID JOHNSON D.D.S. (PRESIDENT)
(847) 741-6217
Entity
Organization

Contact information

Practice address
2090 LARKIN AVE, UNIT ONE-REAR, ELGIN, IL 60123-5845
(847) 741-6217
(847) 741-6217
Mailing address
2090 LARKIN AVE, UNIT ONE-REAR, ELGIN, IL 60123-5845
(847) 741-6217
(847) 741-6217

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
019.020007
IL

Other

Enumeration date
08/28/2012
Last updated
08/28/2012
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