Provider Demographics
NPI:1679794176
Name:PAUL S STONE DDS KEITH E JOHNSON DDS AND ASSOCIATES PA
Entity Type:Organization
Organization Name:PAUL S STONE DDS KEITH E JOHNSON DDS AND ASSOCIATES PA
Other - Org Name:STONE AND JOHNSON DENTAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:STANLEY
Authorized Official - Last Name:STONE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:952-831-1112
Mailing Address - Street 1:3300 EDINBOROUGH WAY
Mailing Address - Street 2:SUITE 210
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55435-5958
Mailing Address - Country:US
Mailing Address - Phone:952-831-1112
Mailing Address - Fax:952-831-1839
Practice Address - Street 1:3300 EDINBOROUGH WAY
Practice Address - Street 2:SUITE 210
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-5958
Practice Address - Country:US
Practice Address - Phone:952-831-1112
Practice Address - Fax:952-831-1839
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty