Individual
THERESA MARIE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
5900 LONG CT, AUSTIN, TX 78730-4919
(512) 653-6931
Mailing address
5900 LONG CT, AUSTIN, TX 78730-4919
(512) 653-6931
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
009098
OH
124Q00000X
Dental Hygienist
Primary
13945
TX
124Q00000X
Dental Hygienist
8336
NC
Other
Enumeration date
02/23/2010
Last updated
02/23/2010
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