Individual
DR. BLAKE ALAN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
124 3RD ST, MARIETTA, OH 45750-3108
(740) 373-1826
(740) 373-1825
Mailing address
124 3RD ST, MARIETTA, OH 45750-3108
(740) 373-1826
(740) 373-1825
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
30-024669
OH
Other
Enumeration date
07/07/2015
Last updated
03/30/2016
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