Organization
STACY D JOHNSON, DDS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STACY DUANE JOHNSON DDS (PRESIDENT)
(317) 535-7141
Entity
Organization
Contact information
Practice address
3056 W STONES CROSSING RD, GREENWOOD, IN 46143-6484
(317) 535-7141
Mailing address
3056 W STONES CROSSING RD, GREENWOOD, IN 46143-6484
(317) 535-7141
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
11/02/2020
Last updated
11/02/2020
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