| Alice J Johnson, Dds, Pa | |
|
5802 Berkamn Dr Suite B Austin TX 78723-2625 | |
| (512) 452-2195 | |
| (512) 452-1871 |
| Full Name | Alice J Johnson, Dds, Pa |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 5802 Berkamn Dr, Austin, Texas |
| Authorized Official Name and Position | Alice J Johnson (PRESIDENT/OWNER) |
| Authorized Official Contact | 5124522195 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Alice J Johnson, Dds, Pa 5802 Berkamn Dr Suite B Austin TX 78723-2625 Ph: (512) 452-2195 | Alice J Johnson, Dds, Pa 5802 Berkamn Dr Suite B Austin TX 78723-2625 Ph: (512) 452-2195 |
| NPI Number | 1164707972 |
|---|---|
| Provider Enumeration Date | 10/13/2011 |
| Last Update Date | 10/13/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164707972 | NPI | - | NPPES |
| 19922049741 | Other | TX | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 17654 (Texas) | Primary |
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