NPI 1063512267

Orvis J. R. Johnson Dds,sc

Organisation Health Maintenance Organization North Fond Du Lac, WI

Practice location

Address: 825 Prospect Ave, North Fond Du Lac, WI 54937-1365
Phone: (920) 923-0310
Fax: (920) 923-5335

Authorised official

Name: Orvis Johnson
Title: Dentist
Phone: (920) 923-0310

Registered specialties

Health Maintenance Organization Primary

Managed Care Organizations Taxonomy 302R00000X Licence 5000785-015 (WI)

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Registry record

NPI: 1063512267
Entity type: Organization
NPI issued: 25 Sep 2006
Record last updated: 22 Aug 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.