Individual
JACK JOHNSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
5140 FM 1252 W, KILGORE, TX 75662-1961
(903) 983-1919
Mailing address
5140 FM 1252 W, KILGORE, TX 75662-1961
(903) 983-1919
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
38441
TX
Other
Enumeration date
06/08/2022
Last updated
06/08/2022
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