Individual
DR. MANDY LYNN JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
900 WEXLER CT, VIRGINIA BEACH, VA 23462-7456
(757) 963-7684
Mailing address
1139 FOUR LEAF LN, HOLLIDAYSBURG, PA 16648-2514
(814) 937-7529
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS036258
PA
1223G0001X
General Practice Dentistry
DS036258
PA
Other
Enumeration date
11/21/2006
Last updated
04/11/2018
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