Individual
DR. RICHARD LEWIS JOHNSON SR.
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DDS, MS
Contact information
Practice address
121 MAIN STREET, EAST JORDAN, MI 49727
(231) 536-1000
(231) 536-9705
Mailing address
PO BOX 1040, 121 MAIN STREET, EAST JORDAN, MI 49727-1040
(231) 536-1000
(231) 536-9705
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
2901010612
MI
Other
Enumeration date
01/04/2006
Last updated
07/08/2007
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