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Individual

DR. JOHN ALLEN JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1709 S FREDERICK AVE, OELWEIN, IA 50662-3106
(319) 283-4090
Mailing address
1709 S FREDERICK AVE, OELWEIN, IA 50662-3106
(319) 283-4090

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6112
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0128504
IA
Enumeration date
07/26/2006
Last updated
07/09/2007
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