Individual
TERESA JOHNS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
132 SAUSALITO BLVD, CASSELBERRY, FL 32707-5764
(407) 665-3400
(407) 665-3408
Mailing address
1227 EAST COLONY DR, MAITLAND, FL 32751
(407) 644-7075
(407) 665-3408
Taxonomy
Speciality
Code
Description
License number
State
1223D0001X
Public Health Dentistry
Primary
DN 17244
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DN17244
LICENSE NUMBER
FL
Enumeration date
08/19/2006
Last updated
07/08/2007
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