Individual
DR. SHANNON POLLY JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
9510 ORMSBY STATION RD STE 203, LOUISVILLE, KY 40223-4083
(028) 050-5005
(502) 771-6041
Mailing address
2913 CREEKSIDE DR, LOUISVILLE, KY 40241-2106
(502) 957-9390
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
7939
KY
122300000X
Dentist
DN 17245
FL
Other
Enumeration date
05/23/2007
Last updated
02/08/2022
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