Individual
DR. DWIGHT JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
12200 15TH ST STE 106, GRANDVIEW, MO 64030-1772
(816) 398-8046
Mailing address
701 E ARMOUR BLVD APT 506, KANSAS CITY, MO 64109-2303
(630) 767-9740
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2018021651
MO
Other
Enumeration date
08/14/2018
Last updated
08/14/2018
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