Mantique Johnson D.D.S

NPI 1417192964 - Dentist - 1223G0001X

NPI Details
NPI 1417192964
Gender Male
Enumeration Date 12/12/2008
Last Updated 12/12/2008
Entity Type Individual
Active Over 7 years ago
Practice Location
75 MARIETTA ST NW
SUITE 100
ATLANTA GA, 30303-2883, US
Phone (404) 577-0868
Fax
Business Location
75 MARIETTA ST NW
SUITE 100
ATLANTA GA, 30303-2883, US
Phone (804) 720-6797
Fax
Toxanomy
Taxonomy Code 1223G0001X
License State Georgia
License Number DN013821
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According to our database, Dr. Mantique Johnson D.D.S NPI is 1417192964, taxonomy code is 1223G0001X and license number is DN013821, license state is located at Georgia. Mantique Johnson D.D.S physically located at 75 Marietta St Nw, Atlanta GA, 30303-2883. NPI Number Mantique Johnson D.D.S has the Individual type.

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1417192964 NPI number is provided on an as is basis without warranty of any kind. 1417192964 is maintained by the National Plan & Provider Enumeration System. The contents of Mantique Johnson D.D.S are for informational purposes only.