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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