Johnson Family Dental, LLC
NPI #1194061564 in Springfield, Illinois
Provider Information
- NPI Number
- 1194061564
- Entity Type
- Organization
- Organization Name
- Johnson Family Dental, LLC
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Dec 12, 2012
- Last Updated
- Dec 12, 2012
Practice Location
- Address
- 2525 W ILES AVE
- City
- Springfield
- State
- Illinois
- ZIP Code
- 62704-4283
- Phone
- (217) 787-7744
Authorized Official
- Name
- RYAN D JOHNSON, D.M.D.
- Title
- DENTIST
- Phone
- (217) 787-7744
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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