Thomas G Johnson | Alexandria, MN • PECOS Search

Thomas G Johnson

Dentist

Dental Providers

700 Cedar St Ste 44, Alexandria, MN 56308-1787

PECOS Enrollment

Based on the most recent information from CMS, provider Thomas G Johnson does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 12:57 PM.

Profile Details

Provider ID
1386830065
Provider Type
Individual
Full Name
Johnson, Thomas G
Title
Dr.
Credential
DDS

Gender
Male
Sole Proprietor
Yes
Enumeration Date
9/17/2007
Last Updated
9/17/2007

Contact Information

Practice Location

700 Cedar St Ste 44, Alexandria, MN 56308-1787

Unlisted Fax

Mailing Location

700 Cedar St Ste 44, Alexandria, MN 56308-1787

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 1223G0001X Primary	Description Dentist Dental Providers	License D7209 Minnesota