Individual
DR. MARK WINTON JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
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
5976
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
633398
UNITED CONCORDIA
NC
05
—
7994645
—
NC
Enumeration date
09/20/2006
Last updated
07/08/2007
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