-- JOHNSON C MIIN -- DDS, MSE
Individual Provider (NPI-1)
Active
Dentist, Oral and Maxillofacial Surgery
Provider Information
- NPI Number
1942463898- Provider Type
- Individual Provider (NPI-1)
- Credentials
- DDS, MSE
- Status
- Active
Contact & Location
- Address
- 1351 MAIN ST, BROCKTON, MA, 023017153
- Phone
- (508) 587-2000
- Fax
- (508) 597-3552
Specialties & Taxonomies
Student in an Organized Health Care Education/Training Program
License: MS
Dentist
License: KY #8512
Dentist, Oral and Maxillofacial Surgery
Primary License: MA #DN1856466
All Addresses
MAILING
1351 MAIN ST
BROCKTON, MA, 023017153