Kevin B. Johnson, DDS

NPI #1568516714 in Sandpoint, Idaho

Provider Information

NPI Number: 1568516714
Entity Type: Organization
Organization Name: Kevin B. Johnson, DDS
Primary Specialty: Dentist
Enumeration Date: Jan 23, 2007
Last Updated: Jun 25, 2008

Practice Location

Address: 1310 PONDEROSA DRIVE
City: Sandpoint
State: Idaho
ZIP Code: 83864
Phone: (208) 263-7641

Authorized Official

Name: DR. KEVIN BRADLEY JOHNSON, DDS
Title: DENTIST OWNER
Phone: (208) 263-7641

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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