Provider Demographics
NPI:1962660605
Name:JOHNSON, PAUL DAVID III (DMD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:DAVID
Last Name:JOHNSON
Suffix:III
Gender:M
Credentials:DMD
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Mailing Address - Street 1:120 S DENTON TAP RD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:COPPELL
Mailing Address - State:TX
Mailing Address - Zip Code:75019-3297
Mailing Address - Country:US
Mailing Address - Phone:469-635-1105
Mailing Address - Fax:469-635-1108
Practice Address - Street 1:1205 W MCDERMOTT DR
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013-6305
Practice Address - Country:US
Practice Address - Phone:469-635-1105
Practice Address - Fax:469-635-1108
Is Sole Proprietor?:No
Enumeration Date:2008-05-29
Last Update Date:2011-11-03
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Provider Licenses
StateLicense IDTaxonomies
TX265261223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics