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Mr. Michael Bruce Johnston, DDS,MS
Pediatric Dentist in Russellville, Arkansas
NPI 1649347634

Michael Bruce Johnston is a Pediatric Dentist based in Russellville, AR and is specialized in Pediatric Dentistry. Michael Bruce Johnston practices in Russellville, AR and has the professional credentials of DDS,MS. The NPI Number for Michael Bruce Johnston is 1649347634 and holds a License No. 2643 (Arkansas).

The current practice location address for Michael Bruce Johnston is 1610 W C Pl, Russellville, AR and can be reached out via phone at 479-968-8338 and via fax at 479-968-1688.

Location: 1610 W C Pl, Russellville, AR, 72801-2705
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1649347634
Provider Name
Michael Bruce Johnston
Credential
DDS,MS
Provider Entity Type
Individual
Gender
Male
Address
1610 W C Pl, Russellville, AR, 72801-2705
Phone Number
479-968-8338
Fax Number
479-968-1688
Provider Enumeration Date
11/29/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
56547 01 AR BLUE CROSS PROVIDER #
545063 01 AZ UNITED CONCORDIA PROV #
institution
Provider Business Practice Location Address Details
Address
1610 W C Pl
City
Russellville
State
Arkansas
Zip
72801-2705
Phone Number
479-968-8338
Fax Number
479-968-1688
person
Provider Business Mailing Address Details
Address
1610 W C Pl
City
Russellville
State
Arkansas
Zip
72801-2705
Phone Number
479-968-8338
Fax Number
479-968-1688
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Pediatric Dentistry
Taxonomy
1223P0221X
License No.
2643 (Arkansas)
Definition
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.
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