Individual
DR. JEFFREY T JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD, MPH
Contact information
Practice address
1080 BEN ALI DRIVE, SUITE A, DANVILLE, KY 40422-2527
(859) 236-6900
(859) 236-6997
Mailing address
1080 BEN ALI DRIVE, SUITE A, DANVILLE, KY 40422-2527
(859) 236-6900
(859) 236-6997
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
7737
KY
1223P0221X
Pediatric Dentistry
Primary
7737
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
60002102
—
KY
Enumeration date
04/14/2006
Last updated
07/17/2015
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