Johnson, Daryl L.
Johnson, Daryl L. is an individual health care provider with primary practice located at 128 Ross St , Molalla OR 97038-9390. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Johnson, Daryl L. can be contacted via phone (503) 829-7677.Contact Information
Primary practice address
128 Ross St
Molalla OR 97038-9390
Phone: (503) 829-7677
Fax: (503) 829-3398
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | D6951 | Oregon |
Profile Details
| NPI number | 1366591273 |
|---|---|
| LBN Legal business name | Johnson, Daryl L. |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 9th, 2007 |
| Last updated | Aug 24th, 2010 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1366591273 | NPPES |
| Oregon | Other | D6951 | STATE LICENSE |
| Oregon | Other | 93-1306543 | STATE LICENSE |
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