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1457484115
ROGER EDMUND JOHANSEN
NEWARK, NJ
NPI
1457484115
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1223P0700X Dentist Prosthodontics
(Licence: NJ 14977)
Enumeration Date
2007-03-13
Last Update Date
2007-07-08
Business Address
DR. ROGER EDMUND JOHANSEN D.M.D.
110 BERGEN ST NJDS ROOM D 837
NEWARK, NJ 07103-2495
Phone number: 973-972-4526
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Mailing Address
DR. ROGER EDMUND JOHANSEN D.M.D.
518 GREGORY AVE A-105
WEEHAWKEN, NJ 07086-5706
Phone number: 201-920-9026
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