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1891756599
EVAN O JOHNSON
IDAHO FALLS, ID
NPI
1891756599
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1223G0001X Dentist, General Practice
(Licence: ID D1853)
Enumeration Date
2006-03-31
Last Update Date
2015-05-19
Business Address
-- EVAN O JOHNSON DMD
1520 ELK CRK
IDAHO FALLS, ID 83404-8322
Phone number: 208-522-8854
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Mailing Address
-- EVAN O JOHNSON DMD
1520 ELK CRK
IDAHO FALLS, ID 83404-8322
Phone number: 208-522-8854
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