Individual
JEFFREY JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2120 VIRGINIA DR, WICHITA FALLS, TX 76309-4646
(940) 761-5979
Mailing address
2120 VIRGINIA DR, WICHITA FALLS, TX 76309-4646
(940) 761-5979
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
30183
TX
Other
Enumeration date
06/30/2014
Last updated
06/30/2014
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