| John S Johnson, Dds | |
|
5102 Salem Ave Lubbock TX 79414-4036 | |
| (806) 687-8080 | |
| (806) 771-6862 |
| Full Name | John S Johnson, Dds |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 5102 Salem Ave, Lubbock, Texas |
| Authorized Official Name and Position | John Johnson (OWNER) |
| Authorized Official Contact | 8066878080 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| John S Johnson, Dds 5102 Salem Ave Lubbock TX 79414-4036 Ph: (806) 687-8080 | John S Johnson, Dds 5102 Salem Ave Lubbock TX 79414-4036 Ph: (806) 687-8080 |
| NPI Number | 1972742302 |
|---|---|
| Provider Enumeration Date | 02/09/2009 |
| Last Update Date | 02/09/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972742302 | NPI | - | NPPES |
| 079145101 | Other | TX | CSHCN (PROGRAM IN TEXAS FOR DISABLED CHILDREN) |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 17087 (Texas) | Primary |
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