Johnson, Kevin Bradley
Johnson, Kevin Bradley is an sole proprietor health care provider with primary practice located at 1310 Ponderosa Dr , Sandpoint ID 83864-5073. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Johnson, Kevin Bradley can be contacted via phone (208) 263-7641.Contact Information
Primary practice address
1310 Ponderosa Dr
Sandpoint ID 83864-5073
Phone: (208) 263-7641
Fax: (208) 265-4333
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | D3287 | Idaho |
Profile Details
| NPI number | 1740615293 |
|---|---|
| LBN Legal business name | Johnson, Kevin Bradley |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 3rd, 2013 |
| Last updated | Sep 11th, 2013 - about 12 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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