Provider Demographics
NPI:1932176161
Name:DONALD E JOHNSON & MICHELLE K DUNLOP DDS PLLP
Entity Type:Organization
Organization Name:DONALD E JOHNSON & MICHELLE K DUNLOP DDS PLLP
Other - Org Name:WOODBURY FAMILY DENTISTS
Other - Org Type:Other Name
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:651-731-8424
Mailing Address - Street 1:8325 CITY CENTRE DR
Mailing Address - Street 2:STE 125
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55125
Mailing Address - Country:US
Mailing Address - Phone:651-731-8424
Mailing Address - Fax:651-731-0917
Practice Address - Street 1:8325 CITY CENTRE DR
Practice Address - Street 2:STE 125
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55125
Practice Address - Country:US
Practice Address - Phone:651-731-8424
Practice Address - Fax:651-731-0917
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty