| Johnson Family Dentistry, Pc | |
|
503 3rd St Ne Devils Lake ND 58301-3015 | |
| (701) 662-4961 | |
| (701) 662-4962 |
| Full Name | Johnson Family Dentistry, Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 503 3rd St Ne, Devils Lake, North Dakota |
| Authorized Official Name and Position | Kirsten A. Andrews (OWNER) |
| Authorized Official Contact | 7016624961 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Johnson Family Dentistry, Pc 503 3rd St Ne Devils Lake ND 58301-3015 Ph: (701) 662-4961 | Johnson Family Dentistry, Pc 503 3rd St Ne Devils Lake ND 58301-3015 Ph: (701) 662-4961 |
| NPI Number | 1780851014 |
|---|---|
| Provider Enumeration Date | 05/15/2008 |
| Last Update Date | 08/11/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780851014 | NPI | - | NPPES |
| 40104 | Medicaid | ND |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 2001 (North Dakota) | Primary |
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