Individual
CRAIG AUSTIN JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2070 VIRGINIA AVE, NORTH BEND, OR 97459-2351
(541) 756-0155
Mailing address
16325 SE MAPLE HILL LN, HAPPY VALLEY, OR 97086-8629
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D11101
OR
Other
Enumeration date
08/12/2019
Last updated
08/12/2019
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