Individual
DR. JEFFREY JAMES JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
4903 E STATE ST, ROCKFORD, IL 61108-2276
(815) 398-2323
(815) 398-2328
Mailing address
4903 E STATE ST, ROCKFORD, IL 61108-2276
(815) 398-2323
(815) 398-2328
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
019
IL
Other
Enumeration date
04/17/2007
Last updated
07/08/2007
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