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General NPI Number Information
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NPI Number | 1811156862
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Entity Type | Individual
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Provider Name | LEO ALVA JOHNS DDS
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Gender | Male
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Dates
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Enumeration Date | 06/05/2008
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Last Update Date | 06/05/2008
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Provider Practice Location Address
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Address Line | 2821 HWY 903 NORTH
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City | MAURY
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State | NC
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Zip | 28554
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Country | US
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Telephone | 252-747-8101
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Fax |
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Provider Business Mailing Address
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Address Line | 226 WHITE OAK BLF
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City | STELLA
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State | NC
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Zip | 28582-9757
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Country | US
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Telephone | 252-393-2898
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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 | 3941
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License Number State | NC
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