| S. Shaun Johanson Dds, Inc. | |
|
1661 Pickett Rd Mckinleyville CA 95519-3914 | |
| (707) 839-3227 | |
| Not Available |
| Full Name | S. Shaun Johanson Dds, Inc. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1661 Pickett Rd, Mckinleyville, California |
| Authorized Official Name and Position | S Shaun Johanson (OWNER) |
| Authorized Official Contact | 7078393227 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| S. Shaun Johanson Dds, Inc. Po Box 2368 Mckinleyville CA 95519-2368 Ph: (707) 839-3227 | S. Shaun Johanson Dds, Inc. 1661 Pickett Rd Mckinleyville CA 95519-3914 Ph: (707) 839-3227 |
| NPI Number | 1003947623 |
|---|---|
| Provider Enumeration Date | 03/07/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003947623 | NPI | - | NPPES |
| B40838-01 | Other | CA | DENTICAL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 40838 (California) | Primary |
Central Dental Care Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1955 Central Ave, Mckinleyville, CA 95519 Phone: 530-370-4484 | |
Lawrence G Johanson Dds, Inc. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1661 Pickett Rd, Mckinleyville, CA 95519 Phone: 707-839-3227 Fax: 707-839-0844 |