Johnson, Mary Carol
Johnson, Mary Carol is an sole proprietor health care provider with primary practice located at 711 High St , Des Moines IA 50392-0001. She recently has only one registered license in Dental Providers / Dentist, which is considered as her primary health care specialty. Johnson, Mary Carol can be contacted via phone (515) 362-2676.Contact Information
Primary practice address
711 High St
Des Moines IA 50392-0001
Phone: (515) 362-2676
Fax: (515) 613-6452
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | 6856 | Iowa |
Profile Details
| NPI number | 1164546305 |
|---|---|
| LBN Legal business name | Johnson, Mary Carol |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 16th, 2007 |
| Last updated | Sep 29th, 2009 - about 17 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 | 1164546305 | NPPES |
| Iowa | MEDICAID | 0209320 | |
| Iowa | Other | 20932 |
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