Individual
MRS. MARICELA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
406B W BOUGHTON RD, BOLINGBROOK, IL 60440-3721
(630) 759-8940
Mailing address
406 W BOUGHTON RD, STE B, BOLINGBROOK, IL 60440-3721
(630) 759-8940
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
020012494
IL
Other
Enumeration date
07/07/2008
Last updated
07/07/2008
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