Douglas Scott Johansen, DDS

NPI #1366571200 in Hartford, Michigan

Provider Information

NPI Number: 1366571200
Entity Type: Individual
Name: Douglas Scott Johansen, DDS
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Dentist
Credential: DDS
Enumeration Date: Mar 5, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 57418 COUNTY ROAD 681
City: Hartford
State: Michigan
ZIP Code: 49057-9421
Phone: (269) 621-3143

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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