Individual
DR. RICHARD L JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD PC
Contact information
Practice address
11565 SW HALL BLVD, SUITE A, TIGARD, OR 97223-8493
(503) 620-2131
(503) 620-0505
Mailing address
11565 SW HALL BLVD, SUITE A, TIGARD, OR 97223-8493
(503) 620-2131
(503) 620-0505
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5430
OR
Other
Enumeration date
09/21/2005
Last updated
07/08/2007
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