Johnson, Bryan J
Johnson, Bryan J is an individual health care provider with primary practice located at 4250 Pontiac Lake Rd Suite B, Waterford MI 48328-1281. He recently has 2 registered licenses in different health care specialties including Dental Providers / Oral and Maxillofacial Surgery, Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery. Dental Providers / Oral and Maxillofacial Surgery is his primary health care specialty. Johnson, Bryan J can be contacted via phone (248) 674-0303.Contact Information
Primary practice address
4250 Pontiac Lake Rd Suite B
Waterford MI 48328-1281
Phone: (248) 674-0303
Fax: (248) 674-2947
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Oral and Maxillofacial Surgery | 1223S0112X | BJ017615 | Michigan |
| Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery | 204E00000X | BJ017615 | Michigan |
Profile Details
| NPI number | 1740384981 |
|---|---|
| LBN Legal business name | Johnson, Bryan J |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 8th, 2006 |
| Last updated | Jun 27th, 2014 - about 10 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1740384981 | NPPES |
| Michigan | Other | 190F37120 | BCBS OF MI |
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