NPI 1003189366

John Joseph Johnson, DDS

Practitioner Dentist Lewiston, ID

Practice location

Address: 3510 12th Street Suite #600, Lewiston, ID 83501
Phone: (208) 798-7955
Fax: (208) 798-7957

Registered specialties

Dentist Primary

Dental Providers Taxonomy 122300000X Licence D-3189 (ID)

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Registry record

NPI: 1003189366
Entity type: Individual
Sex (as registered): Male
NPI issued: 17 Feb 2012
Record last updated: 17 Feb 2012

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.