| Dr. Warren Johnson, Dds | |
|
422 Heritage Place Faribault MN 55021 | |
| (507) 334-5602 | |
| (507) 334-3488 |
| Full Name | Dr. Warren Johnson, Dds |
|---|---|
| Speciality | Dentist |
| Location | 422 Heritage Place, Faribault, Minnesota |
| Authorized Official Name and Position | Warren D Johnson (OWNER/PRACTICE) |
| Authorized Official Contact | 5073345602 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr. Warren Johnson, Dds 422 Heritage Place Faribault MN 55021 Ph: (507) 334-5602 | Dr. Warren Johnson, Dds 422 Heritage Place Faribault MN 55021 Ph: (507) 334-5602 |
| NPI Number | 1568606283 |
|---|---|
| Provider Enumeration Date | 04/24/2009 |
| Last Update Date | 04/24/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568606283 | NPI | - | NPPES |
| 950017100 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 7748 (Minnesota) | Primary |
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