| Paul W. Johnson,ph.d., D.m.d., Inc. | |
|
8007 Laguna Blvd Suite 1 Elk Grove CA 95758-7920 | |
| (916) 691-6442 | |
| (916) 691-6452 |
| Full Name | Paul W. Johnson,ph.d., D.m.d., Inc. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 8007 Laguna Blvd, Elk Grove, California |
| Authorized Official Name and Position | Paul William Johnson (PRESIDENT) |
| Authorized Official Contact | 9166916442 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Paul W. Johnson,ph.d., D.m.d., Inc. 8007 Laguna Blvd Suite 1 Elk Grove CA 95758-7920 Ph: (916) 691-6442 | Paul W. Johnson,ph.d., D.m.d., Inc. 8007 Laguna Blvd Suite 1 Elk Grove CA 95758-7920 Ph: (916) 691-6442 |
| NPI Number | 1154492239 |
|---|---|
| Provider Enumeration Date | 11/13/2006 |
| Last Update Date | 05/21/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154492239 | NPI | - | NPPES |
| 45854197 | Other | CA | STATE EMPLOYER ID |
| 680448471 | Other | CA | INDIVIDUAL EMPLOYER ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 43798 (California) | Primary |
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