Individual
JOHN ANTHONY JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D., M.D.
Contact information
Practice address
858 BRAWLEY SCHOOL RD, STE C, MOORESVILLE, NC 28117-6852
(704) 799-3555
(704) 799-3095
Mailing address
858 BRAWLEY SCHOOL RD, STE C, MOORESVILLE, NC 28117-6852
(704) 799-3555
(704) 799-3095
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
89136CU
—
NC
Enumeration date
06/21/2005
Last updated
07/08/2007
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