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Dr. Kirby Charles Johnson, DDS
Oral and Maxillofacial Surgery (Dentist) in St Anthony, Minnesota
NPI 1023045341

Kirby Charles Johnson is a Oral and Maxillofacial Surgery (Dentist) based in Medina, MN and is specialized in Oral and Maxillofacial Surgery. Kirby Charles Johnson practices in St Anthony, MN and has the professional credentials of DDS. The NPI Number for Kirby Charles Johnson is 1023045341 and holds a License No. 10472DDS (Minnesota).

The current practice location address for Kirby Charles Johnson is 3905 Silver Lake Rd, St Anthony, MN and can be reached out via phone at 612-788-9246 and via fax at 612-788-5511.

Location: 3905 Silver Lake Rd, St Anthony, MN, 55340
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1023045341
Provider Name
Kirby Charles Johnson
Credential
DDS
Provider Entity Type
Individual
Gender
Male
Address
3905 Silver Lake Rd, St Anthony, MN, 55340
Phone Number
612-788-9246
Fax Number
612-788-5511
Provider Enumeration Date
06/26/2006
Last Update Date
03/08/2024
institution
Provider Business Practice Location Address Details
Address
3905 Silver Lake Rd
City
St Anthony
State
Minnesota
Zip
55421
Phone Number
612-788-9246
Fax Number
612-788-5511
person
Provider Business Mailing Address Details
Address
3905 Silver Lake Rd
City
St Anthony
State
Minnesota
Zip
55421
Phone Number
612-788-9246
Fax Number
612-788-5511
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Oral and Maxillofacial Surgery
Taxonomy
1223S0112X
License No.
10472DDS (Minnesota)
Definition
The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
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