LARRY JOHNSON

CHAMPAIGN, IL
NPI1356472765
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1223G0001X Dentist, General Practice
(Licence: IL  019019226)
Enumeration Date2007-03-08
Last Update Date2007-07-08
Business Address
-- LARRY JOHNSON DDS
919 W KIRBY AVE SUITE 4
CHAMPAIGN, IL 61821-5121
Phone number: 217-352-9494
Mailing Address
-- LARRY JOHNSON DDS
PO BOX 3487
CHAMPAIGN, IL 61826-3487
Phone number: 217-352-9494
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