JERRY LEE JOHNSON

WORTHINGTON, MN
NPI1316975568
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1223G0001X Dentist, General Practice
(Licence: MN  10185)
Additional Taxonomies1223G0001X Dentist, General Practice
(Licence: IA  7092)
Enumeration Date2006-06-28
Last Update Date2007-07-08
Business Address
Dr. JERRY LEE JOHNSON D.D.S
1316 MCMILLAN ST
WORTHINGTON, MN 56187-1646
Phone number: 507-376-5525
Mailing Address
Dr. JERRY LEE JOHNSON D.D.S
29847 260TH ST
WORTHINGTON, MN 56187-6365
Phone number: 507-376-9253