Johnson, John Anthony

Johnson, John Anthony is an individual health care provider with primary practice located at 858 Brawley School Rd Ste C, Mooresville NC 28117-6852. He recently has only one registered license in Dental Providers / Oral and Maxillofacial Surgery, which is considered as his primary health care specialty. Johnson, John Anthony can be contacted via phone (704) 799-3555.

Contact Information

Primary practice address
858 Brawley School Rd Ste C Mooresville NC 28117-6852
Phone: (704) 799-3555
Fax: (704) 799-3095
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X North Carolina

Profile Details

NPI number 1639174162
LBN Legal business name Johnson, John Anthony
Credentials D.M.D., M.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 21st, 2005
Last updated Jul 8th, 2007 - about 18 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1639174162 NPPES
North Carolina MEDICAID 89136CU

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