Individual
EDWARD L. JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
928 STATE ROUTE 716, ASHLAND, KY 41102-9231
(606) 928-3866
(606) 928-3848
Mailing address
928 STATE ROUTE 716, ASHLAND, KY 41102-9231
(606) 928-3866
(606) 928-3848
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5483
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
531257
UNITED CONCORDIA
KY
05
—
60054830
—
KY
01
—
Y461
BC/BS
KY
Enumeration date
09/15/2006
Last updated
07/08/2007
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