Individual
DR. R RYAN JOHANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
7613 JORDAN LANDING BLVD, SUITE 210, WEST JORDAN, UT 84084-1972
(801) 280-9595
(801) 280-1169
Mailing address
7613 JORDAN LANDING BLVD, SUITE 210, WEST JORDAN, UT 84084-1972
(801) 280-9595
(801) 280-1169
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
49534949922
UT
Other
Enumeration date
02/15/2007
Last updated
07/08/2007
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