Individual
STACY DUANE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
3056 W STONES CROSSING RD, GREENWOOD, IN 46143
(317) 535-7141
(317) 535-7142
Mailing address
3056 W STONES CROSSING RD, GREENWOOD, IN 46143
(317) 535-7141
(317) 535-7142
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12009239
IN
Other
Enumeration date
01/09/2007
Last updated
08/28/2007
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