| Mark W Johnson, Dmd, Pc | |
|
487 N Main St Ste B Thayne WY 83127-9768 | |
| (307) 883-4222 | |
| Not Available |
| Full Name | Mark W Johnson, Dmd, Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 487 N Main St Ste B, Thayne, Wyoming |
| Authorized Official Name and Position | Mark Johnson (DENTIST) |
| Authorized Official Contact | 3078834222 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mark W Johnson, Dmd, Pc 487 N Main St Ste B Thayne WY 83127-9768 Ph: (307) 883-4222 | Mark W Johnson, Dmd, Pc 487 N Main St Ste B Thayne WY 83127-9768 Ph: (307) 883-4222 |
| NPI Number | 1073204533 |
|---|---|
| Provider Enumeration Date | 05/16/2023 |
| Last Update Date | 05/16/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073204533 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
Star Valley Oral Surgery Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 487 N Main, Suite B, Thayne, WY 83127 Phone: 307-883-4222 Fax: 307-883-4222 |