Individual
DR. GINA B. JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
2230 TOWNE LAKE PARKWAY, BLDG 1300, STE 100, WOODSTOCK, GA 30189
(678) 445-5444
(678) 445-5552
Mailing address
PO BOX 195, WOODSTOCK, GA 30188
(678) 445-5444
(678) 445-5552
Taxonomy
Speciality
Code
Description
License number
State
1223D0001X
Public Health Dentistry
DN011762
GA
1223G0001X
General Practice Dentistry
Primary
DN011762
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
102101
AVESIS
GA
01
—
9210146
DORAL DENTAL
GA
05
—
9980277608B
—
GA
Enumeration date
02/13/2007
Last updated
08/30/2021
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