Organization
WILLIAM R. JOHNSON, DMD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ELAINE A JOHNSON (OFFICE MANAGER/SPOUSE)
(502) 448-0678
Entity
Organization
Contact information
Practice address
4007 VALLEY VIEW DR, LOUISVILLE, KY 40216-4221
(502) 448-0678
(502) 448-6292
Mailing address
4007 VALLEY VIEW DR, LOUISVILLE, KY 40216-4221
(502) 448-0678
(502) 448-6292
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
9805
KY
1223P0221X
Pediatric Dentistry
Primary
5700
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
60057007
—
KY
05
—
7100484350
—
KY
Enumeration date
03/27/2018
Last updated
03/27/2018
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