Most Relevant Information
Provider Data
| NPI Number: | 1003286055 |
| Provider Name: | MARY ANN JOHNSON D.M.D. |
| Entity Type: | Individual |
| Taxonomy Code: | 1223G0001X |
| Specialty: | Dentist |
| License Number: | DEN.00202717 |
Most Important Dates
| Enumeration Date: | 10/02/2015 |
| Last Updated: | 04/04/2017 |
Provider Practice Location
320 COMANCHE ST.
KIOWA
CO
80117
Practice Location Phone/Fax
| Phone: | 7203899763 |
| Fax: |
Provider Mailing Location
3205 N ACADEMY BLVD
SUITE 130
COLORADO SPRINGS
CO
809175147
Provider Mailing Phone/Fax
| Phone: | 7196325700 |
| Fax: |