Organization
LAWRENCE G JOHANSON DDS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAWRENCE GUNNAR JOHANSON DDS (CEO)
(707) 839-3227
Entity
Organization
Contact information
Practice address
1661 PICKETT RD, MCKINLEYVILLE, CA 95519-3914
(707) 839-3227
(707) 839-0844
Mailing address
PO BOX 2368, 1661 PICKETT RD, MCKINLEYVILLE, CA 95519-2368
(707) 839-3227
(707) 839-0844
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
18244
CA
Other
Enumeration date
05/05/2008
Last updated
05/05/2008
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