Organization
DR. MARK W. JOHNSON, PA
Active
Organization
DR. MARK W. JOHNSON, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK WINTON JOHNSON D.M.D., M.S. (VICE PRESIDENT)
(252) 638-6177
Entity
Organization
Contact information
Practice address
604 MCCARTHY BLVD, NEW BERN, NC 28562-5231
(252) 638-6177
(252) 638-5269
Mailing address
604 MCCARTHY BLVD, NEW BERN, NC 28562-5231
(252) 638-6177
(252) 638-5269
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
1223S0112X
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0242G
BCBS
NC
05
—
790242G
—
NC
Enumeration date
11/08/2006
Last updated
09/09/2020
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