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1497836704
KENNETH WAYNE JOHNSON
TUPELO, MS
NPI
1497836704
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1223P0221X Dentist, Pediatric Dentistry
(Licence: MS pedo29796)
Enumeration Date
2006-10-17
Last Update Date
2007-07-08
Business Address
Dr. KENNETH WAYNE JOHNSON D.D.S.
704 HILLCREST
TUPELO, MS 38804
Phone number: 662-840-8540
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Mailing Address
Dr. KENNETH WAYNE JOHNSON D.D.S.
1407 MITTS DR
TUPELO, MS 38801-2215
Phone number: 662-840-8540
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