Dr. Jerry Lamar Johnston, D.D.S.
Dentist in Ruston, LA. Individual provider (NPI-1).
NPI number1124148689
StatusActive
Last updated in NPPESNov 2, 2022
Details
- NPI
- 1124148689
- Entity type
- Individual (NPI-1)
- Name
- Dr. Jerry Lamar Johnston
- Credential
- D.D.S.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Mar 29, 2007
- Certification date
- Nov 2, 2022
- Last updated
- Nov 2, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | 3839 | LA | Yes |
Practice location
306 E Reynolds DrRuston, LA 71270-2846
Phone 318-255-6780 · Fax 318-255-6778
Mailing address
306 E Reynolds DrRuston, LA 71270-2846
Phone 318-255-6780 · Fax 318-255-6778
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