MEDICARE: DR. JOHN M JOYNER D.M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	DN15037	FL

General Provider Information

NPI Number	:	1093930414
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN M JOYNER D.M.D.

Provider Business Mailing Address
First Line	:	140 SAWBILL PALM DR
Second Line	:
City	:	PONTE VEDRA
State	:	FL
Zip	:	32082-3840
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2220 COUNTY ROAD 210 W
Second Line	:	SUITE 312
City	:	JACKSONVILLE
State	:	FL
Zip	:	32259-4058
Country	:	US
Telephone Number	:	904-825-9960
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/13/2007
Last Update Date	:	07/08/2007

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