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General NPI Number Information
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NPI Number | 1437274883
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Entity Type | Organization
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Legal Business Name | S. MEREDITH JOHNSON, JR., D.M.D. PC
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Dates
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Enumeration Date | 03/21/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2946 E 10TH ST BUILDING B
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City | JEFFERSONVILLE
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State | IN
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Zip | 47130-5914
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Country | US
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Telephone | 812-288-8880
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Fax |
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Provider Business Mailing Address
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Address Line | 2946 E 10TH ST BUILDING B
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City | JEFFERSONVILLE
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State | IN
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Zip | 47130-5914
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Country | US
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Telephone | 812-288-8880
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Fax |
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. S. MEREDITH JOHNSON JR.
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Credential | D.M.D.
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Telephone | 812-288-8880
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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 | 6785
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License Number State | IN
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