Individual
MS. MAUREEN ANNE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH CDHC
Contact information
Practice address
210 WOOD LAKE DR SE, SUITE B, ROCHESTER, MN 55904-5529
(507) 424-1040
(507) 424-1042
Mailing address
4114 3RD ST NW, ROCHESTER, MN 55901-7564
(507) 252-9776
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
H3878
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
030993100
MA PROVIDER #
MN
Enumeration date
11/29/2006
Last updated
06/13/2008
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