Brock Allen Johnsen, D.D.S.

NPI #1114068616 in Shelby, Michigan

Provider Information

NPI Number: 1114068616
Entity Type: Individual
Name: Brock Allen Johnsen, D.D.S.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist
Credential: D.D.S.
Enumeration Date: Feb 9, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 4140 W SHELBY RD
City: Shelby
State: Michigan
ZIP Code: 49455-9660
Phone: (231) 861-4858

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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