Individual
DR. BRIAN M JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S. S.C.
Contact information
Practice address
1838 DUNLAP AVE, MARINETTE, WI 54143-1722
(715) 735-5626
(715) 735-3283
Mailing address
1838 DUNLAP AVE, PO BOX 480, MARINETTE, WI 54143-1722
(715) 735-5626
(715) 735-3283
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1467G
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33504900
—
WI
Enumeration date
01/16/2007
Last updated
07/09/2007
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