Individual
DR. LORI D JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
127 N HAYDEN ST, BELZONI, MS 39038-3931
(662) 318-5050
Mailing address
PO BOX 68844, JACKSON, MS 39286-8844
(601) 665-0013
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
3710-13
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03637810
—
MS
Enumeration date
06/26/2012
Last updated
09/16/2015
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