Alice J Johnson, Dds, Pa

NPI 1164707972 - Clinic/Center - 261QD0000X

NPI Details
NPI 1164707972
Enumeration Date 10/13/2011
Last Updated 10/13/2011
Entity Type Healthcare Provider
Active Over 5 years ago
Authorized Information
Name ALICE J ALICE
Position PRESIDENT/OWNER
Phone (512) 452-2195
Fax (512) 452-1871
Practice Location
5802 BERKAMN DR
SUITE B
AUSTIN TX, 78723-2625, US
Phone (512) 452-2195
Fax (512) 452-1871
Business Location
5802 BERKAMN DR
SUITE B
AUSTIN TX, 78723-2625, US
Phone (512) 452-2195
Fax (512) 452-1871
Toxanomy
Taxonomy Code 261QD0000X
License State Texas
License Number 17654
Remove 1164707972 NPI Number
 

According to our database, Alice J Johnson, Dds, Pa NPI is 1164707972, taxonomy code is 261QD0000X and license number is 17654, license state is located at Texas. Alice J Johnson, Dds, Pa physically located at 5802 Berkamn Dr, Austin TX, 78723-2625. NPI Number 1033115704 has the healthcare provider type.

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1164707972 NPI number is provided on an as is basis without warranty of any kind. 1164707972 is maintained by the National Plan & Provider Enumeration System. The contents of Alice J Johnson, Dds, Pa are for informational purposes only.