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1912058280
KENNETH O JOHNSON
SOUTH HOLLAND, IL
NPI
1912058280
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1223G0001X Dentist, General Practice
(Licence: IL 019018099)
Enumeration Date
2007-01-15
Last Update Date
2007-07-08
Business Address
-- KENNETH O JOHNSON DDS
438 E 162ND ST
SOUTH HOLLAND, IL 60473-2258
Phone number: 708-333-0699
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Mailing Address
-- KENNETH O JOHNSON DDS
438 E 162ND ST
SOUTH HOLLAND, IL 60473-2258
Phone number: 708-333-0699
Copy
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