Individual
DR. DARYL LANCE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
1313 W HIGHWAY 8, CLEVELAND, MS 38732-2240
(662) 843-8353
(662) 843-8303
Mailing address
1313 W HIGHWAY 8, CLEVELAND, MS 38732-2240
(662) 843-8353
(662) 843-8303
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2826-94
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00660091
—
MS
Enumeration date
08/03/2006
Last updated
10/14/2020
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