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General NPI Number Information
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NPI Number | 1851646798
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Entity Type | Organization
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Legal Business Name | ANTHONY G. JOHNSON, D.D.S., P.C.
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Dates
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Enumeration Date | 07/17/2012
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Last Update Date | 07/17/2012
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Provider Practice Location Address
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Address Line | 6525 BELCREST ROAD SUITE 290
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City | HYATTSVILLE
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State | MD
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Zip | 20782
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Country | US
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Telephone | 301-699-0029
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Fax |
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Provider Business Mailing Address
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Address Line | 6525 BELCREST ROAD SUITE 290
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City | HYATTSVILLE
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State | MD
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Zip | 20782
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Country | US
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Telephone | 301-699-0029
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Fax |
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Authorized Official
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Title or Position | PEDIATRIC DENTIST
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Name | DR. ANTHONY G. JOHNSON
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Credential | D.D.S.
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Telephone | 301-699-0029
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 12800
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License Number State | MD
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