Provider Demographics
NPI:1225154263
Name:ANDREW P. JOHNSON D.D.S. PC
Entity Type:Organization
Organization Name:ANDREW P. JOHNSON D.D.S. PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:PARKER
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:434-392-8185
Mailing Address - Street 1:PO BOX 494
Mailing Address - Street 2:1707 E. THIRD ST.
Mailing Address - City:FARMVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23901-0494
Mailing Address - Country:US
Mailing Address - Phone:434-392-8185
Mailing Address - Fax:434-392-8186
Practice Address - Street 1:1707 EAST THIRD STREET
Practice Address - Street 2:
Practice Address - City:FARMVILLE
Practice Address - State:VA
Practice Address - Zip Code:23901-0401
Practice Address - Country:US
Practice Address - Phone:434-392-8185
Practice Address - Fax:434-392-8186
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-21
Last Update Date:2012-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty