Individual
DR. KEVIN BROOKS JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
333 NW 3RD AVE, CANBY, OR 97013-3602
(503) 266-2705
(503) 266-2973
Mailing address
333 NW 3RD AVE, CANBY, OR 97013-3602
(503) 266-2705
(503) 266-2973
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D9406
OR
122300000X
Dentist
DE00010704
WA
Other
Enumeration date
12/20/2006
Last updated
04/11/2012
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