Individual
DR. RAYMOND JAMES JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D
Contact information
Practice address
15 SHADY RIDGE RD, RUSSELL, PA 16345-1135
(814) 688-9214
Mailing address
15 SHADY RIDGE RD, RUSSELL, PA 16345-1135
(814) 688-9214
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS040004
PA
Other
Enumeration date
06/12/2014
Last updated
05/05/2015
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