Provider Demographics
NPI:1164787982
Name:JOHNSON, LAUREN R (DMD)
Entity Type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:R
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:R
Other - Last Name:BRENNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:52 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:NEW BOSTON
Mailing Address - State:NH
Mailing Address - Zip Code:03070-4027
Mailing Address - Country:US
Mailing Address - Phone:603-487-2106
Mailing Address - Fax:
Practice Address - Street 1:52 HIGH ST
Practice Address - Street 2:
Practice Address - City:NEW BOSTON
Practice Address - State:NH
Practice Address - Zip Code:03070-4027
Practice Address - Country:US
Practice Address - Phone:603-487-2106
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-09
Last Update Date:2023-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH039101223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice