Provider Demographics
NPI:1336794908
Name:JOHNSON AND VARSANIK, PLLC
Entity type:Organization
Organization Name:JOHNSON AND VARSANIK, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:R
Authorized Official - Last Name:VARSANIK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:734-347-2042
Mailing Address - Street 1:5347 CRYSTAL CREEK LN
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:MI
Mailing Address - Zip Code:48094-2674
Mailing Address - Country:US
Mailing Address - Phone:810-516-3482
Mailing Address - Fax:
Practice Address - Street 1:1460 WALTON BLVD
Practice Address - Street 2:SUITE 205
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48309-4843
Practice Address - Country:US
Practice Address - Phone:734-347-2042
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-09
Last Update Date:2019-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental