| Charles D. Johnson, Dds | |
|
607 W Church St Booneville MS 38829-2647 | |
| (662) 728-8133 | |
| (662) 728-6903 |
| Full Name | Charles D. Johnson, Dds |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 607 W Church St, Booneville, Mississippi |
| Authorized Official Name and Position | Joan Rorie (OFFICE MANAGER) |
| Authorized Official Contact | 6627288133 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Charles D. Johnson, Dds 607 W Church St Booneville MS 38829-2647 Ph: (662) 728-8133 | Charles D. Johnson, Dds 607 W Church St Booneville MS 38829-2647 Ph: (662) 728-8133 |
| NPI Number | 1629299847 |
|---|---|
| Provider Enumeration Date | 05/02/2007 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629299847 | NPI | - | NPPES |
| 00004329 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (Mississippi) | Primary |
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