Johnson, J Terry

Johnson, J Terry is an sole proprietor health care provider with primary practice located at 427 E Kanesville Blvd Suite 306, Council Bluffs IA 51503-4403. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Johnson, J Terry can be contacted via phone (712) 328-1885.

Contact Information

Primary practice address
427 E Kanesville Blvd Suite 306 Council Bluffs IA 51503-4403
Phone: (712) 328-1885
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 5907 Iowa

Profile Details

NPI number 1639143316
LBN Legal business name Johnson, J Terry
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 17th, 2006
Last updated Jul 9th, 2007 - about 19 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1639143316 NPPES
Iowa MEDICAID 0119693

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