Kenneth O Johnson, DDS
NPI #1912058280 in South Holland, Illinois
Provider Information
- NPI Number
- 1912058280
- Entity Type
- Individual
- Name
- Kenneth O Johnson, DDS
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Dentist - General Practice
- Credential
- DDS
- Enumeration Date
- Jan 15, 2007
- Last Updated
- Jul 8, 2007
Practice Location
- Address
- 438 E 162ND ST
- City
- South Holland
- State
- Illinois
- ZIP Code
- 60473-2258
- Phone
- (708) 333-0699
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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