Individual
DR. GREGORY M JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1063 W PEARCE BLVD, WENTZVILLE, MO 63385-1019
(636) 327-6880
(636) 327-6881
Mailing address
1063 W PEARCE BLVD, WENTZVILLE, MO 63385-1019
(636) 327-6880
(636) 327-6881
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2003012143
IN
Other
Enumeration date
01/30/2007
Last updated
07/08/2007
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