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General NPI Number Information
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NPI Number | 1073909321
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Entity Type | Organization
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Legal Business Name | ERNEST N. JOHNSON, DDS, PC
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Dates
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Enumeration Date | 04/14/2015
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Last Update Date | 04/14/2015
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Provider Practice Location Address
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Address Line | 2933 W CACTUS RD
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City | PHOENIX
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State | AZ
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Zip | 85029-2346
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Country | US
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Telephone | 602-863-9079
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Fax |
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Provider Business Mailing Address
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Address Line | 2933 W CACTUS RD
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City | PHOENIX
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State | AZ
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Zip | 85029-2346
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Country | US
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Telephone | 602-863-9079
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ERNEST JOHNSON
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Credential | DDS
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Telephone | 602-863-9079
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 284300000X
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Taxonomy Name | Special Hospital
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License Number |
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License Number State |
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