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Individual

MR. DAVID THOMAS JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.M.D

Contact information

Practice address
117 SULPHUR SPRINGS RD, MURFREESBORO, TN 37129-2117
(615) 895-2710
Mailing address
117 SULPHUR SPRINGS RD, MURFREESBORO, TN 37129-2117
(615) 895-2710

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
7261
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
3057892
BLUE CROSS BLUE SHIELD ID
TN
01
621681497
TAX ID
TN
01
7261
STATE LICENSE NUMBER
TN
01
985347
UNITED CONCORDIA ID
TN
Enumeration date
04/23/2007
Last updated
07/08/2007
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