Jacob Lynn Johnson, DMD Valid NPI

Individual provider · Military Health Care Provider · Sheppard Afb, TX

NPI

1982120895

Type

Individual (Type 1)

Primary specialty

Military Health Care Provider

Specialty group

Other Service Providers

Taxonomy code

171000000X

License number

34858 (TX)

Sex

Male

Sole proprietor

Yes

Enumerated

2017-08-22

Last updated

2023-08-20