Individual
DR. PAUL C. JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
8240 NAAB RD STE 365, INDIANAPOLIS, IN 46260-1987
(317) 872-3282
(317) 879-8085
Mailing address
8240 NAAB RD STE 365, INDIANAPOLIS, IN 46260-1987
(317) 872-3282
(317) 879-8085
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12008585B
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10023710
—
IN
01
—
785770
UNITED HEALTHCARE
IN
Enumeration date
08/24/2006
Last updated
07/08/2007
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