| Cole J. Johnson Dds Pa | |
|
2420 S 51st Ct Fort Smith AR 72903-3669 | |
| (479) 452-2995 | |
| Not Available |
| Full Name | Cole J. Johnson Dds Pa |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2420 S 51st Ct, Fort Smith, Arkansas |
| Authorized Official Name and Position | Cole Jerome Johnson (OWNER/PRESIDENT) |
| Authorized Official Contact | 4794522995 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cole J. Johnson Dds Pa 2420 S 51st Ct Fort Smith AR 72903-3669 Ph: (479) 452-2995 | Cole J. Johnson Dds Pa 2420 S 51st Ct Fort Smith AR 72903-3669 Ph: (479) 452-2995 |
| NPI Number | 1144618307 |
|---|---|
| Provider Enumeration Date | 12/22/2014 |
| Last Update Date | 12/22/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144618307 | NPI | - | NPPES |
| 199375608 | Medicaid | AR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 3867 (Arkansas) | Primary |
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