| Lawrence G Johanson Dds, Inc. | |
|
1661 Pickett Rd Mckinleyville CA 95519-3914 | |
| (707) 839-3227 | |
| (707) 839-0844 |
| Full Name | Lawrence G Johanson Dds, Inc. |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1661 Pickett Rd, Mckinleyville, California |
| Authorized Official Name and Position | Lawrence Gunnar Johanson (CEO) |
| Authorized Official Contact | 7078393227 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lawrence G Johanson Dds, Inc. Po Box 2368 1661 Pickett Rd Mckinleyville CA 95519-2368 Ph: (707) 839-3227 | Lawrence G Johanson Dds, Inc. 1661 Pickett Rd Mckinleyville CA 95519-3914 Ph: (707) 839-3227 |
| NPI Number | 1598931974 |
|---|---|
| Provider Enumeration Date | 05/05/2008 |
| Last Update Date | 05/05/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598931974 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 18244 (California) | Primary |
S. Shaun Johanson Dds, Inc. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1661 Pickett Rd, Mckinleyville, CA 95519 Phone: 707-839-3227 | |
Central Dental Care Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1955 Central Ave, Mckinleyville, CA 95519 Phone: 530-370-4484 |