Organization
GREGORY P JOHNSON DDS MS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY PACKER JOHNSON DDS (PRESIDENT)
(949) 552-5800
Entity
Organization
Contact information
Practice address
5394 WALNUT AVE STE H, IRVINE, CA 92604-2591
(949) 552-5800
(949) 552-8905
Mailing address
5394 WALNUT AVE STE H, IRVINE, CA 92604-2591
(949) 552-5800
(949) 552-8905
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
D22813
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
B22813
DENTICAL
CA
01
—
CGP097860
CALIFORNIA CHILDREN'S SERVICES
CA
01
—
CGP171091
CALIFORNIA CHILDREN'S SERVICES
CA
Enumeration date
12/27/2011
Last updated
12/30/2011
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