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Individual

DR. STEPHEN JOHANSEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S., PC

Contact information

Practice address
7370 CREEK RD STE 202, SANDY, UT 84093-6113
(801) 676-1234
(801) 676-5678
Mailing address
7370 CREEK RD STE 202, SANDY, UT 84093-6113
(801) 676-1234
(801) 676-5678

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
UT

Other

Enumeration date
08/23/2007
Last updated
08/23/2007
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