Individual
TRAVIS ALLAN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
9950 VALLEY CREEK RD STE 100, WOODBURY, MN 55125-5803
(651) 578-7000
(651) 578-0157
Mailing address
9950 VALLEY CREEK RD STE 100, WOODBURY, MN 55125-5803
(651) 578-7000
(651) 578-0157
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
D13205
MN
Other
Enumeration date
05/24/2013
Last updated
05/19/2020
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