Individual
PAUL JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1411 FALLS AVE E STE 1000C, TWIN FALLS, ID 83301-3459
(208) 734-7415
Mailing address
1411 FALLS AVE E STE 1000C, TWIN FALLS, ID 83301-3459
(208) 734-7415
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D-4745
ID
122300000X
Dentist
DE60293839
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1023850
—
WA
Enumeration date
07/18/2012
Last updated
10/20/2016
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