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Individual

DR. AN-LOUISE JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DMD, MD

Contact information

Practice address
56 NEW DRIFTWAY, SUITE 309, SCITUATE, MA 02066-4533
(781) 545-6565
(781) 545-6597
Mailing address
PO BOX 363, SCITUATE, MA 02066-0363
(781) 545-6565
(781) 545-6597

Taxonomy

Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
20760
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00020760
DELTA DENTAL
MA
01
11477985
AETNA HEALTH CARE
MA
01
494138
TUFTS HEALTH PLAN
MA
01
98018
FALLON HEALTH CARE
MA
01
AA37401
HARVARD PILGRAM HEALTH CA
MA
01
X12124
BLUE CROSS AND BLUE SHIEL
MA
Enumeration date
07/10/2006
Last updated
07/08/2007
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