| Gregory P Johnson Dds Ms Inc | |
|
5394 Walnut Ave Ste H Irvine CA 92604-2591 | |
| (949) 552-5800 | |
| (949) 552-8905 |
| Full Name | Gregory P Johnson Dds Ms Inc |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 5394 Walnut Ave Ste H, Irvine, California |
| Authorized Official Name and Position | Gregory Packer Johnson (PRESIDENT) |
| Authorized Official Contact | 9495525800 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gregory P Johnson Dds Ms Inc 5394 Walnut Ave Ste H Irvine CA 92604-2591 Ph: (949) 552-5800 | Gregory P Johnson Dds Ms Inc 5394 Walnut Ave Ste H Irvine CA 92604-2591 Ph: (949) 552-5800 |
| NPI Number | 1790054344 |
|---|---|
| Provider Enumeration Date | 12/27/2011 |
| Last Update Date | 12/30/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790054344 | NPI | - | NPPES |
| CGP171091 | Other | CA | CALIFORNIA CHILDREN'S SERVICES |
| B22813 | Other | CA | DENTICAL |
| CGP097860 | Other | CA | CALIFORNIA CHILDREN'S SERVICES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | D22813 (California) | Primary |
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