Kevin Bradley Johnson, D.D.S. Valid NPI

Individual provider · General Practice Dentistry · Sandpoint, ID

NPI

1740615293

Type

Individual (Type 1)

Primary specialty

General Practice Dentistry (Dentist)

Specialty group

Dental Providers

Taxonomy code

1223G0001X

License number

D3287 (ID)

Sex

Male

Sole proprietor

Yes

Enumerated

2013-09-03

Last updated

2013-09-11