Organization Name: | PAUL A. JOHNSON DDS INC |
NPI Number: | 1235527557 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | PAUL AARON JOHNSON (PRESIDENT) |
Mailing Address: | 2101 Stone Blvd Suite 130 West Sacramento |
State: | CA US |
Postal Code: | 956914044 |
Phone Number: | 9162278055 |
Fax Number: | 9162667513 |
NPI Enumeration Date: | 01/09/2015 |
NPI Last Update Date: | 01/09/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1223P0221X |
License Number: | 57809 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Dental Providers |
Taxonomy Classification: | Dentist |
Taxonomy Specialization: | Pediatric Dentistry |
Taxonomy Definition: | An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |