MEDICARE: DR. JOHNNA SUE BRITT D.D.S.

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	9896	MD

General Provider Information

NPI Number	:	1881768273
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHNNA SUE BRITT D.D.S.

Provider Business Mailing Address
First Line	:	29 E FREDERICK ST
Second Line	:
City	:	WALKERSVILLE
State	:	MD
Zip	:	21793-8234
Country	:	US
Telephone Number	:	310-845-4844
Fax Number	:

Provider Business Practice Location Address
First Line	:	29 E FREDERICK ST
Second Line	:
City	:	WALKERSVILLE
State	:	MD
Zip	:	21793-8234
Country	:	US
Telephone Number	:	310-845-4844
Fax Number	:

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

Provider Enumeration Date	:	11/20/2006
Last Update Date	:	07/08/2007

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