Individual
DR. BRENT DAVID JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
70 WESTRIDGE PKWY STE 200, MCDONOUGH, GA 30253-3048
(678) 583-0330
(678) 583-0660
Mailing address
70 WESTRIDGE PKWY STE 200, MCDONOUGH, GA 30253-3048
(678) 583-0330
(678) 583-0660
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN015686
GA
Other
Enumeration date
06/08/2018
Last updated
07/23/2019
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