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General NPI Number Information
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NPI Number | 1578633699
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Entity Type | Organization
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Legal Business Name | ROBERT J. JOHNSON, D.D.S., P.C.
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Dates
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Enumeration Date | 11/08/2006
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Last Update Date | 01/02/2008
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Provider Practice Location Address
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Address Line | 400 LAKE ST STE 101
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City | ONTONAGON
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State | MI
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Zip | 49953-1034
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Country | US
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Telephone | 906-884-4040
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Fax | 906-884-4080
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Provider Business Mailing Address
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Address Line | 400 LAKE ST STE 101
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City | ONTONAGON
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State | MI
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Zip | 49953-1034
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Country | US
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Telephone | 906-884-4040
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Fax | 906-884-4080
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Authorized Official
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Title or Position | DENTIST
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Name | DR. ROBERT J JOHNSON
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Credential | D.D.S.
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Telephone | 906-884-4040
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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 | 2901009242
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License Number State | MI
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