Organization
KIRBY M. JOHNSON, D.D.S., LLC
Active
Other names
Green Lake Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KIRBY MELVIN JOHNSON D.D.S. (PRESIDENT)
(320) 796-2158
Entity
Organization
Contact information
Practice address
163 HIGHWAY 23 NE STE 1, SPICER, MN 56288-9735
(320) 796-2158
(320) 409-1180
Mailing address
163 HIGHWAY 23 NE STE 1, SPICER, MN 56288-9735
(320) 796-2158
(320) 409-1180
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
04/10/2015
Last updated
02/02/2023
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