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Organization

EDDIE P JOHNSON III, DMD, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. EDDIE P JOHNSON III DMD (DENTIST)
(706) 790-9179
Entity
Organization

Contact information

Practice address
2755 BARTON CHAPEL RD, AUGUSTA, GA 30906
(706) 790-9179
(706) 790-3408
Mailing address
2755 BARTON CHAPEL RD, AUGUSTA, GA 30906-9579
(706) 790-9179
(706) 790-3408

Taxonomy

Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
009685
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00254526C
GA
Enumeration date
12/23/2011
Last updated
12/23/2011
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