Organization
NISSWA DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CRAIG BRIAN JOHNSON DDS (OWNER / DENTIST)
(218) 963-2970
Entity
Organization
Contact information
Practice address
25579 CHURCH ST, NISSWA, MN 56468-2834
(218) 963-2970
Mailing address
PO BOX 157, NISSWA, MN 56468-0157
(218) 963-2970
(218) 963-9502
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
05/15/2025
Last updated
05/15/2025
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