Kenneth A Johnson DDS LLC
Clinic/Center, Dental in Arlington Heights, IL. Organization (NPI-2).
NPI number1114744331
StatusActive
Last updated in NPPESSep 20, 2024
Details
- NPI
- 1114744331
- Entity type
- Organization (NPI-2)
- Legal business name
- Kenneth A Johnson DDS LLC
- Organization subpart
- No
- Enumeration date
- Sep 20, 2024
- Certification date
- Sep 20, 2024
- Last updated
- Sep 20, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QD0000X | Clinic/Center, Dental | – | – | Yes |
Practice location
1531 W Campbell StArlington Heights, IL 60005-1513
Phone 847-373-3936
Mailing address
2909 Scottlynne DrPark Ridge, IL 60068-2854
Phone 773-719-9559
Authorized official
Kenneth A Johnson
Owner
7737199559
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