Individual provider · Type 1 NPI
Kenneth Wayne Johnson, DDS
Pediatric Dentistry · Tupelo, MS
NPI number
1497836704
Active
Practice location
704 Hillcrest
Tupelo, MS 38804
Fax (662) 840-0629
Mailing address
1407 Mitts Dr
Tupelo, MS 38801-2215
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Pediatric Dentistry Primary | 1223P0221X | PEDO29796 (MS) |
Pediatric Dentistry: 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.
Other pediatric dentistry providers in Tupelo
About NPI 1497836704
Kenneth Wayne Johnson, DDS's National Provider Identifier is 1497836704, issued on Oct 17, 2006. The primary taxonomy on file is Pediatric Dentistry (1223P0221X), and the practice location is in Tupelo, MS. The record was last updated on Jul 8, 2007.