Orvis Johnson, D.D.S Valid NPI

Individual provider · General Practice Dentistry · North Fond Du Lac, WI

NPI

1679596316

Type

Individual (Type 1)

Primary specialty

General Practice Dentistry (Dentist)

Specialty group

Dental Providers

Taxonomy code

1223G0001X

License number

5000785-015 (WI)

Sex

Male

Sole proprietor

Yes

Enumerated

2006-07-25

Last updated

2007-07-08