Organization
MILLENNIUM DENTAL, PLLC
Active
Other names
C. Chad Johnson, D.D.S., P.A.
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICIA L WEBB (BUSINESS MANAGER)
(479) 521-4440
Entity
Organization
Contact information
Practice address
2827 E MILLENNIUM PL STE 1, FAYETTEVILLE, AR 72703-6528
(479) 521-4440
(479) 521-4443
Mailing address
2827 E MILLENNIUM PL STE 1, FAYETTEVILLE, AR 72703-6528
(479) 521-4440
(479) 521-4443
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
AR3377
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1437163599
NPI NUMBER INDIVIDUAL
AR
Enumeration date
05/30/2007
Last updated
08/22/2020
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