Individual
DONALD RICHARD JOHNSON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
718 HARRIS AVE, RAEFORD, NC 28376-3113
(910) 875-8181
(910) 875-6361
Mailing address
718 HARRIS AVE, RAEFORD, NC 28376-3113
(910) 875-8181
(910) 875-6361
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4209
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8994606
—
NC
Enumeration date
10/19/2006
Last updated
07/08/2007
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