Kellie Anita Johnson, DDS

NPI #1346337375 in Ft Worth, Texas

Provider Information

NPI Number: 1346337375
Entity Type: Individual
Name: Kellie Anita Johnson, DDS
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist - General Practice
Credential: DDS
Enumeration Date: Oct 10, 2006
Last Updated: Jul 8, 2007

Practice Location

Address: 815 E BERRY ST # B
City: Ft Worth
State: Texas
ZIP Code: 76110-4414
Phone: (817) 920-5919

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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