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Contact Information

BRYAN D. JOHNSON, DDS, PA
516 MAIN STREET
MADISON LAKE, MN56063
 Phone: 507-243-3747
 Fax: 507-243-3866
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
Indicates primary specialty

NPI Profile & details for BRYAN D JOHNSON DDS PA · (Female)

NPI # 1043208267
Status Active
Credentials
Entity Individual
Enumeration date 10/11/2005
Last updated 08/22/2020 - About 6 years ago
Sole proprietor 1 Not specified
Identifiers
  • MN License # D9815
  • MN Other 41321JO BLUE CROSS BLUE SHIELD
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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