| Jean D Johnson | |
|
2201 5th Street Hollow Rd Ste 2 Bloomsburg PA 17815-7757 | |
| (570) 458-6731 | |
| Not Available |
| Full Name | Jean D Johnson |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 2201 5th Street Hollow Rd Ste 2, Bloomsburg, Pennsylvania |
| Authorized Official Name and Position | Jean Johnson (OWNER) |
| Authorized Official Contact | 5704586731 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jean D Johnson 2201 5th Street Hollow Rd Ste 2 Bloomsburg PA 17815-7757 Ph: (570) 458-6731 | Jean D Johnson 2201 5th Street Hollow Rd Ste 2 Bloomsburg PA 17815-7757 Ph: (570) 458-6731 |
| NPI Number | 1427729532 |
|---|---|
| Provider Enumeration Date | 09/28/2021 |
| Last Update Date | 09/28/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427729532 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
| 332BC3200X | Durable Medical Equipment & Medical Supplies - Customized Equipment | (* (Not Available)) | Secondary |
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