| NPI | 1023451325 |
|---|---|
| Former Name | MICHIA JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: MD 15550) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: VA 0401420264) |
| Enumeration Date | 2013-04-17 |
| Last Update Date | 2026-09-09 |