Organization
CONTEMPORARY PERIODONTICS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TRUMAN CHRISTOPHER JOHNSON DDS, MS (PRESIDENT)
(319) 363-9880
Entity
Organization
Contact information
Practice address
3900 RIVER RIDGE DRIVE NE, SUITE A, CEDAR RAPIDS, IA 52402-7599
(319) 363-9880
(319) 363-8386
Mailing address
3900 RIVER RIDGE DRIVE NE, SUITE A, CEDAR RAPIDS, IA 52402-7599
(319) 363-9880
(319) 363-8386
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
7959
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00980081
UNITED CONCORDIA
—
01
—
46932
WELLMARK BCBS
IA
Enumeration date
11/29/2006
Last updated
06/27/2012
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