Doctor Name: | DR. MATTHEW BEN JOHNSON |
NPI Number: | 1356533822 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | D.D.S. |
License Number: | 22481 |
Business Practice Address: | 119 Cimarron Park Loop C Buda, TX - 786102839 |
Business Phone Number: | 5122957600 |
Business Fax Number: | 5122957633 |
Mailing Address: | 119 Cimarron Park Loop, C BUDA |
State: | TX |
Postal Code: | 786102839 |
Phone Number: | 5122957600 |
Fax Number: | 5122957633 |
NPI Enumeration Date: | 08/17/2007 |
NPI Last Update Date: | 07/14/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1223P0221X |
License Number: | 22481 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
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. |