NPI: 1154489938
Provider Name: NORTH STAR CHILDREN'S DENTISTRY, PC
Former Legal Business Name: GREGORY L. JOHNSON, DDS, PC
Classification: Dentist - 1223P0221X
Entity Type: Organization
Specialization: Pediatric Dentistry
Address:
114 MINNIE ST
SUITE A
FAIRBANKS, AK
ZIP 99701
Phone: (907) 452-4509
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NORTH STAR CHILDREN'S DENTISTRY, PC is a pediatric dentistry dentist in Fairbanks, AK. The provider is 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. NORTH STAR CHILDREN'S DENTISTRY, PC NPI is 1154489938. The provider is registered as an organization entity type and is a single specialty group.
The provider Former Legal Business Name Is Gregory L. Johnson, Dds, Pc.
The provider's business location address is:
114 MINNIE ST
SUITE A
FAIRBANKS, AK
ZIP 99701-006
Phone: (907) 452-4509
Fax: (907) 457-4509
The provider's authorized official is Gregory L. Johnson .
The authorized official title is President and has the following contact phone number (907) 452-4509.
The enumeration date for this NPI number is 12/5/2006 and was last updated on 5/8/2009.