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Kenneth Johnson, DDS
NPI 1912058280 · on the registry since 2007
Practice
- Address
- 438 E 162nd St
South Holland, IL 60473 - Phone
- (708) 333-0699
- Fax
- (708) 333-8252
- Organisation at this address
- South Park Dental Care
Inferred from a shared address, not stated in the registry.
Registry record
- Primary taxonomy
- 1223G0001X
1223G0001X
- Licence states on file
- IL
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2007-07-08
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois