Individual
ROBERT JACKSON JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
150 55TH ST, BROOKLYN, NY 11220-2508
(718) 630-7000
Mailing address
947 N 50 E, KAYSVILLE, UT 84037-1203
Taxonomy
Speciality
Code
Description
License number
State
1223D0004X
Dental Anesthesiology
Primary
11770
TN
1223D0004X
Dental Anesthesiology
4405-23
MS
1223D0004X
Dental Anesthesiology
D012025
AZ
Other
Enumeration date
02/18/2020
Last updated
06/12/2024
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