Individual
DR. DALE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
724 CEDAR ST, SAULT SAINTE MARIE, MI 49783-2410
(906) 632-2020
Mailing address
724 CEDAR ST, SAULT SAINTE MARIE, MI 49783-2410
(906) 632-2020
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901002749
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DJ002749
BCBS
MI
01
—
P31680002
MEDICARE PLUS BLUE
MI
Enumeration date
05/12/2006
Last updated
07/29/2015
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