Individual
DOMINIQUE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2151 ROCKFORD ST, MOUNT AIRY, NC 27030-5205
(336) 429-4146
Mailing address
5807 GARDEN VILLAGE CT # 5807K, GREENSBORO, NC 27410-8715
(908) 510-0272
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
13428
NC
Other
Enumeration date
06/13/2023
Last updated
08/03/2023
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