Provider Demographics
NPI:1669940284
Name:FOCUS DENTAL PLLC
Entity type:Organization
Organization Name:FOCUS DENTAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:WELLS
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:II
Authorized Official - Credentials:DDS
Authorized Official - Phone:254-213-5773
Mailing Address - Street 1:128 PORTAFINO LN
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78633-5172
Mailing Address - Country:US
Mailing Address - Phone:253-254-2912
Mailing Address - Fax:
Practice Address - Street 1:360 W CENTRAL TEXAS EXPY STE 203
Practice Address - Street 2:
Practice Address - City:HARKER HEIGHTS
Practice Address - State:TX
Practice Address - Zip Code:76548-1891
Practice Address - Country:US
Practice Address - Phone:254-680-3727
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-13
Last Update Date:2018-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental