Individual
KELLY ANN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
2020 N WEBB RD STE 301, WICHITA, KS 67206-3410
(316) 687-2110
Mailing address
229 S BLECKLEY DR, WICHITA, KS 67218-1521
(316) 250-6090
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
KS60821
KS
Other
Enumeration date
06/05/2012
Last updated
02/11/2025
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