MR. Keith E Johnson

NPI #1952529133 in Boulder Creek, California

Provider Information

NPI Number: 1952529133
Entity Type: Individual
Name: MR. Keith E Johnson
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Dentist - General Practice
Enumeration Date: Apr 23, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 13270 BIG BASIN WAY
City: Boulder Creek
State: California
ZIP Code: 95006
Phone: (831) 338-2131

Specialties & Taxonomy Codes

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

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