Individual
DR. KELLY JAMES JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1 JARRETT WHITE RD, TRIPLER ARMY MEDICAL CENTER, HI 96859-5001
(808) 655-8825
Mailing address
1 JARRETT WHITE RD, TRIPLER ARMY MEDICAL CENTER, HI 96859-5001
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
5336421-9922
UT
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
5336421-9922
UT
Other
Enumeration date
08/10/2006
Last updated
02/28/2023
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