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General NPI Number Information
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NPI Number | 1407321250
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Entity Type | Organization
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Legal Business Name | C JOHNSON DDS PLLC
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Dates
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Enumeration Date | 10/08/2018
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Last Update Date | 10/08/2018
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Provider Practice Location Address
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Address Line | 8840 BLAKENEY PROFESSIONAL DR STE 202
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City | CHARLOTTE
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State | NC
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Zip | 28277-6718
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Country | US
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Telephone | 704-688-0070
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Fax |
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Provider Business Mailing Address
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Address Line | 8111 CONCORD MILLS BLVD STE 209
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City | CONCORD
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State | NC
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Zip | 28027-6468
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Country | US
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Telephone | 704-979-3333
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. JEFFREY CHAD JOHNSON
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Credential | DDS
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Telephone | 704-743-7278
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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