Individual
DR. LISA MARI JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1015 NW 4TH ST, GRAND RAPIDS, MN 55744
(218) 326-0339
(218) 326-6210
Mailing address
1015 NW 4TH ST, GRAND RAPIDS, MN 55744
(218) 326-0339
(218) 326-6210
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
11285
MN
Other
Enumeration date
12/18/2006
Last updated
07/08/2007
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