| J. Grant Johansen Dmd Pllc | |
|
3800 W Ray Rd Ste 11 Chandler AZ 85226-5940 | |
| (480) 345-0530 | |
| (480) 345-0048 |
| Full Name | J. Grant Johansen Dmd Pllc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 3800 W Ray Rd Ste 11, Chandler, Arizona |
| Authorized Official Name and Position | Justin Grant Johansen (DENTIST, OWNER) |
| Authorized Official Contact | 4802546712 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| J. Grant Johansen Dmd Pllc 3800 W Ray Rd Ste 11 Chandler AZ 85226-5940 Ph: (480) 345-0530 | J. Grant Johansen Dmd Pllc 3800 W Ray Rd Ste 11 Chandler AZ 85226-5940 Ph: (480) 345-0530 |
| NPI Number | 1316416621 |
|---|---|
| Provider Enumeration Date | 11/15/2018 |
| Last Update Date | 11/15/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316416621 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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