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Individual

DR. KEENON JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DDS, MS

Contact information

Practice address
10208 CERNY ST, SUITE 304, RALEIGH, NC 27617-7884
(919) 706-0617
(919) 825-3361
Mailing address
10208 CERNY ST, SUITE 304, RALEIGH, NC 27617-7884
(919) 706-0617
(919) 825-3361

Taxonomy

Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
8669
NC

Other

Enumeration date
07/11/2007
Last updated
01/10/2012
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