DR. Gregory Wade Johnson, D.D.S

NPI #1568671873 in Coweta, Oklahoma

Provider Information

NPI Number: 1568671873
Entity Type: Individual
Name: DR. Gregory Wade Johnson, D.D.S
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Dentist - General Practice
Credential: D.D.S
Enumeration Date: May 22, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 129 S BROADWAY
City: Coweta
State: Oklahoma
ZIP Code: 74429-4101
Phone: (918) 279-8880

Specialties & Taxonomy Codes

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

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