Individual
DR. SCOTT A JOHNSON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.D.S., M.D.
Contact information
Practice address
3940 INGERSOLL AVE, DES MOINES, IA 50312-3506
(515) 274-9151
(515) 274-1472
Mailing address
3940 INGERSOLL AVE, DES MOINES, IA 50312-3506
(515) 274-9151
(515) 274-1472
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
07989
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
36325
MEDICAL LICENSE NUMBER
IA
Enumeration date
01/30/2006
Last updated
07/08/2007
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