Mary Beth Johnson in Polacca - Pediatric Dentistry

Mary Beth Johnson - NPI 1437292570

Mary Beth Johnson is a Pediatric Dentistry in Polacca, Arizona. Mary Beth Johnson practices all healthcare services and medical treatments related to Pediatric Dentistry. The NPI Number for Mary Beth Johnson is 1437292570. The last update date is 2009-06-26.

Mary Beth Johnson's current location address is Hwy 264, Mp 388, Polacca, Arizona. You can contact this provider via phone number 9287376162. The mailing address for Mary Beth Johnson is Hwy 264, Mp 388, Polacca, Arizona. To know further, please read the information below!

Provider Profile Detail

Provider Name Mary Beth Johnson
Address Hwy 264, Mp 388, Polacca, Arizona
Phone Number 9287376162
Fax Number
Sole Proprietor N
Credentials DDS

NPI Number Detail

NPI Number 1437292570
Provider Enumeration Date 2007-02-15
Last Updated Date 2009-06-26

Provider Mailing Address Detail

Address Hwy 264, Mp 388
City Polacca
State Arizona (AZ)
Post Code 86042
Phone Number 9287376162
Fax Number

Provider's Primary Taxonomy Detail

Speciality Pediatric Dentistry
Taxonomy 1223P0221X
Licence No 30-020478
Definition:
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.

Provider's Other Legacy Identifiers

Identifier Identifier Type Identifier State Identifier Issuer
420456 AZ --

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FAQs about Mary Beth Johnson

What is the unique identification code assigned to Mary Beth Johnson by the Centers for Medicare & Medicaid Services?

The Mary Beth Johnson has been issued the NPI (National Provider Identifier) 1437292570. This 10-digit code serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).

Could you provide the complete address where Mary Beth Johnson is physically located?

The Mary Beth Johnson is situated at the following address: Hwy 264, Mp 388, Polacca, AZ 86042.

What is Mary Beth Johnson's primary area of medical expertise, and what taxonomy classification code corresponds to this specialized field?

The primary area of medical expertise for Mary Beth Johnson is Pediatric Dentistry, and the corresponding taxonomy classification code for this specialized field is 1223P0221X.

On what date did the Centers for Medicare & Medicaid Services originally issue the 1437292570 to Mary Beth Johnson?

The Centers for Medicare & Medicaid Services originally issued the 1437292570 to Mary Beth Johnson on 2007-02-15.

As of what date were the details related to Mary Beth Johnson most recently updated or revised?

The information pertaining to Mary Beth Johnson, including its address, specialty, and other relevant details, was last updated or revised on 2009-06-26.

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