Organization
CASA GRANDE PEDIATRIC DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES JOHNSON DMD (MEMBER)
(520) 421-1400
Entity
Organization
Contact information
Practice address
1968 N PEART RD STE 19, CASA GRANDE, AZ 85122-2497
(520) 421-1400
(520) 421-1444
Mailing address
1968 N PEART RD STE 19, CASA GRANDE, AZ 85122-2497
(520) 421-1400
(520) 421-1444
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
D05410
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
587800
—
AZ
Enumeration date
05/13/2013
Last updated
05/13/2013
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