Kissendrah Sue Johnson

NPI #1124502984 in Isleta, New Mexico

Provider Information

NPI Number: 1124502984
Entity Type: Individual
Name: Kissendrah Sue Johnson
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist
Enumeration Date: Sep 18, 2018
Last Updated: Sep 18, 2018

Practice Location

Address: 01 SAGEBRUSH STREET
City: Isleta
State: New Mexico
ZIP Code: 87022
Phone: (505) 869-4866

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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