| Peter F Johnson Dmd A Professional Corporation | |
|
5565 Grossmont Center Dr Suite 110-1 La Mesa CA 91942-3020 | |
| (619) 463-3737 | |
| (619) 463-3730 |
| Full Name | Peter F Johnson Dmd A Professional Corporation |
|---|---|
| Speciality | Dentist - Prosthodontics |
| Location | 5565 Grossmont Center Dr, La Mesa, California |
| Authorized Official Name and Position | Peter Fink Johnson (PRESIDENT) |
| Authorized Official Contact | 6194633737 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Peter F Johnson Dmd A Professional Corporation 5565 Grossmont Center Dr Suite 110-1 La Mesa CA 91942-3020 Ph: (619) 463-3737 | Peter F Johnson Dmd A Professional Corporation 5565 Grossmont Center Dr Suite 110-1 La Mesa CA 91942-3020 Ph: (619) 463-3737 |
| NPI Number | 1023334711 |
|---|---|
| Provider Enumeration Date | 04/20/2010 |
| Last Update Date | 06/22/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023334711 | NPI | - | NPPES |
| D25550 | Other | CA | PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0700X | Dentist - Prosthodontics | D25550 (California) | Primary |
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