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General NPI Number Information
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NPI Number | 1457799884
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Entity Type | Individual
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Provider Name | KATIE KREMER JOHNSON DDS
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Gender | Female
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Dates
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Enumeration Date | 06/07/2013
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Last Update Date | 07/10/2024
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Provider Practice Location Address
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Address Line | 1514 E MINNESOTA ST
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City | SAINT JOSEPH
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State | MN
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Zip | 56374-8618
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Country | US
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Telephone | 320-363-7729
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Fax |
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Provider Business Mailing Address
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Address Line | 22 17TH AVE N
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City | COLD SPRING
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State | MN
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Zip | 56320-4595
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Country | US
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Telephone | 320-290-9339
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 13247
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License Number State | MN
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