Individual
CIERRA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
208 HOSPITAL DR NE, FORT WALTON BEACH, FL 32548-5068
(850) 243-8124
Mailing address
208 HOSPITAL DR NE, FORT WALTON BEACH, FL 32548-5068
(850) 243-8124
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN23076
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/10/2017
Last updated
09/07/2022
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