Organization
MARQUETTE COUNTY HEALTH DEPARTMENT DENTAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RANDALL M JOHNSON M.D. (MEDICAL DIRECTOR HEALTH OFFICER)
(906) 315-2607
Entity
Organization
Contact information
Practice address
989 W WASHINGTON ST STE 104, MARQUETTE, MI 49855-4073
(906) 226-9992
Mailing address
184 US HIGHWAY 41 E, NEGAUNEE, MI 49866
(906) 475-9977
(906) 475-9312
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
88131
DELTA DENTAL
MI
01
—
D80157
BCBS OF MI
MI
Enumeration date
05/09/2007
Last updated
08/22/2020
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