| NPI | 1134358476 |
|---|---|
| Former Name | HEATHER N. JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: ND 2083) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: WI 6419) |
| Enumeration Date | 2009-07-08 |
| Last Update Date | 2011-03-10 |