Organization
RYAN A JOHNSON DDS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RYAN A JOHNSON D.D.S. (MANAGING PARTNER)
(918) 260-2395
Entity
Organization
Contact information
Practice address
400 FAIRVIEW AVE, SUITE 6, PONCA CITY, OK 74601-1920
(580) 765-2589
(580) 762-2199
Mailing address
400 FAIRVIEW AVE, SUITE 6, PONCA CITY, OK 74601-1920
(580) 765-2589
(580) 762-2199
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6592
OK
Other
Enumeration date
06/02/2014
Last updated
06/02/2014
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