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Individual

DR. TODD A JOHNSON

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
5207 UNIVERSITY AVE NE, COLUMBIA HEIGHTS, MN 55421-1649
(763) 572-8040
(763) 502-2310
Mailing address
5207 UNIVERSITY AVE NE, COLUMBIA HEIGHTS, MN 55421-1649
(763) 572-8040
(763) 502-2310

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
9081
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
24227JO
BLUE CROSS & BLUE SHIELD
MN
Enumeration date
04/27/2006
Last updated
07/08/2007
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