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Provider Information for 1851559843



DR. ERIC SCOTT JOHNSON DDS

Gender: MALE

Individual NPI: 1851559843

Calendar   Last Updated:  2010-04-30
  Certification Date: 

Details

Name Value
NPI 1851559843
Enumeration Date 2008-05-28
NPI Type 1 - Individual
Sole Proprietor YES
Status Active
Mailing Address 647 CAMINO DE LOS MARES STE 209
SAN CLEMENTE, CA 92673-2807
United States

Phone: 949-493-9311 | Fax:
View Map External Link
Primary Practice Address 647 CAMINO DE LOS MARES STE 209
SAN CLEMENTE, CA 92673-2807
United States

Phone: 949-493-9311 | Fax:
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 122300000X - Dentist TX 23846