Individual
DERRICK JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5410 LYNX LN #290, COLUMBIA, MD 21044
(410) 910-9716
Mailing address
45 N 6TH ST APT 391, ALLENTOWN, PA 18101-1104
(425) 999-5913
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
18589
MD
Other
Enumeration date
05/07/2025
Last updated
05/07/2025
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