Individual
DR. CAVOUR DAMON JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
303 POWELL AVENUE, COLERAINE, MN 55722
(218) 245-2451
Mailing address
PO BOX J, COLERAINE, MN 55722
(218) 245-2451
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D7759
MN
Other
Enumeration date
12/14/2006
Last updated
07/08/2007
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