Individual
DR. DALE ALAN JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1717 W CHURCH ST, FREEPORT, IL 61032-4695
(815) 233-9777
(815) 232-1312
Mailing address
1717 W CHURCH ST, FREEPORT, IL 61032-4695
(815) 233-9777
(815) 232-1312
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
IL
Other
Enumeration date
10/02/2006
Last updated
07/08/2007
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