Lane Johnson Valid NPI
Individual provider · Dentist · Travis Afb, CA
- NPI
- 1639623366
- Type
- Individual (Type 1)
- Primary specialty
- Dentist
- Specialty group
- Dental Providers
- Taxonomy code
- 122300000X
- License number
- 30.24851 (OH)
- Sex
- Female
- Sole proprietor
- No
- Enumerated
- 2016-08-11
- Last updated
- 2016-08-11
Practice location
151 Bodin Cir
Travis Afb, CA 94535-1801
(207) 939-4284