Organization
ERIC JOHNSON LLC
Active
Other names
Smile Colorado Family Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ERIC M JOHNSON DMD (OWNER)
(602) 697-0934
Entity
Organization
Contact information
Practice address
9101 PEARL ST #217, THORNTON, CO 80229-8022
(303) 576-9016
Mailing address
9101 PEARL ST STE 217, THORNTON, CO 80229-4353
(303) 576-9016
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
202569
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9000143289
—
CO
Enumeration date
01/10/2018
Last updated
01/10/2018
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