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General NPI Number Information
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NPI Number | 1295946663
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Entity Type | Individual
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Provider Name | WILLIAM WALTER JOHNSON D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 05/25/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 40TH & HOLDREGE STREETS
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City | LINCOLN
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State | NE
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Zip | 68583
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Country | US
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Telephone | 402-472-9406
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Fax |
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Provider Business Mailing Address
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Address Line | 2901 SW 74TH ST
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City | LINCOLN
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State | NE
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Zip | 68532-9187
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 6246
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License Number State | NE
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