Dominique Johnson
Dentist in Mount Airy, NC. Individual provider (NPI-1).
NPI number1750065447
StatusActive
Last updated in NPPESAug 3, 2023
Details
- NPI
- 1750065447
- Entity type
- Individual (NPI-1)
- Name
- Dominique Johnson
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jun 13, 2023
- Certification date
- Aug 3, 2023
- Last updated
- Aug 3, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | 13428 | NC | Yes |
Practice location
2151 Rockford StMount Airy, NC 27030-5205
Phone 336-429-4146
Mailing address
5807 Garden Village Ct # 5807kGreensboro, NC 27410-8715
Phone 908-510-0272
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