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General NPI Number Information
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NPI Number | 1922116755
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Entity Type | Individual
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Provider Name | WILLIAM LOUIS JOHNSON III DDS
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Gender | Male
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Dates
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Enumeration Date | 08/29/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 550 PEACHTREE ST SUITE 1160
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City | ATLANTA
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State | GA
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Zip | 30308
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Country | US
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Telephone | 404-524-0007
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Fax | 404-524-2775
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Provider Business Mailing Address
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Address Line | 11 ROSE GATE DR NE
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City | ATLANTA
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State | GA
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Zip | 30342-4160
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Country | US
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Telephone | 404-252-6608
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Fax | 404-252-6643
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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 | 6973
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License Number State | GA
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