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General NPI Number Information
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NPI Number | 1578677290
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Entity Type | Individual
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Provider Name | TERESA JOHNS DMD
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Gender | Female
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Dates
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Enumeration Date | 08/19/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 132 SAUSALITO BLVD
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City | CASSELBERRY
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State | FL
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Zip | 32707-5764
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Country | US
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Telephone | 407-665-3400
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Fax | 407-665-3408
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Provider Business Mailing Address
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Address Line | 1227 EAST COLONY DR
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City | MAITLAND
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State | FL
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Zip | 32751
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Country | US
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Telephone | 407-644-7075
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Fax | 407-665-3408
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223D0001X
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Taxonomy Name | Public Health Dentistry
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License Number | DN 17244
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License Number State | FL
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