Provider Demographics
NPI:1750302485
Name:JOHNSON, NEAL CURTIS (DMD)
Entity Type:Individual
Prefix:DR
First Name:NEAL
Middle Name:CURTIS
Last Name:JOHNSON
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:176 S 32ND ST W STE 3
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-6867
Mailing Address - Country:US
Mailing Address - Phone:406-656-2700
Mailing Address - Fax:406-652-0485
Practice Address - Street 1:176 S 32ND ST W STE 3
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-6867
Practice Address - Country:US
Practice Address - Phone:406-656-2700
Practice Address - Fax:406-652-0485
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2020-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT20621223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0112472Medicaid
MT710893479OtherEMPLOYER IDENTIFICATION #