Individual
DR. JOHNNY ROMAN VIDIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
351 WEST 6TH STREET, BLDG 440, USA DENTAC - ATTN: CREDENTIALS, FORT STEWART, GA 31314-4704
(912) 767-6735
(912) 870-6735
Mailing address
351 WEST 6TH STREET, BLDG 440, USA DENTAC - ATTN: CREDENTIALS, FORT STEWART, GA 31314-4704
(912) 767-6735
(912) 870-6735
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
13776
MD
Other
Enumeration date
08/09/2006
Last updated
05/13/2016
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