Provider Demographics
NPI:1811090863
Name:JOHNSON, WARD WINSLOW (DDS)
Entity type:Individual
Prefix:DR
First Name:WARD
Middle Name:WINSLOW
Last Name:JOHNSON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:720 E HYMAN AVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:ASPEN
Mailing Address - State:CO
Mailing Address - Zip Code:81611
Mailing Address - Country:US
Mailing Address - Phone:970-925-2544
Mailing Address - Fax:970-920-3381
Practice Address - Street 1:720 E HYMAN AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:ASPEN
Practice Address - State:CO
Practice Address - Zip Code:81611
Practice Address - Country:US
Practice Address - Phone:970-925-2544
Practice Address - Fax:970-920-3381
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6744122300000X
IA07399122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist