Provider Demographics
NPI:1548644008
Name:DE GRAFT-JOHNSON, ANNA (ENDODONTIST)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:DE GRAFT-JOHNSON
Suffix:
Gender:F
Credentials:ENDODONTIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1415 HIGHWAY 6
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-4987
Mailing Address - Country:US
Mailing Address - Phone:281-491-0069
Mailing Address - Fax:281-491-0083
Practice Address - Street 1:1415 HIGHWAY 6
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-4987
Practice Address - Country:US
Practice Address - Phone:281-491-0069
Practice Address - Fax:281-491-0083
Is Sole Proprietor?:No
Enumeration Date:2015-07-15
Last Update Date:2020-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX333531223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics