Gary R. Johnson, D.d.s., P.c.

NPI #1366466930 in Berkeley, Illinois

Provider Information

NPI Number
1366466930
Entity Type
Organization
Organization Name
Gary R. Johnson, D.d.s., P.c.
Primary Specialty
Clinic/Center - Dental
Enumeration Date
Jul 27, 2006
Last Updated
Oct 26, 2015

Practice Location

Address
5646 SAINT CHARLES RD
Address 2
SUITE C
ZIP Code
60163-1148
Phone
(708) 544-7474

Authorized Official

Name
DR. GARY ROBERT JOHNSON, D.D.S.
Title
PRESIDENT
Phone
(708) 544-7474

Specialties & Taxonomy Codes

Specialty
Clinic/Center - DentalDental

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