Organization
PENSACOLA PATRIOT DENTAL PLLC
Active
Other names
Patriot Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN KEITH LISONBEE DMD (CEO)
(850) 758-1844
Entity
Organization
Contact information
Practice address
4627 N DAVIS HWY STE A, PENSACOLA, FL 32503-2364
(850) 477-1120
Mailing address
4627 N DAVIS HWY STE A, PENSACOLA, FL 32503-2364
(850) 477-1120
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
08/06/2021
Last updated
08/06/2021
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