Individual
DR. PATRICK TODD JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D., P.A.
Contact information
Practice address
5111 EHRLICH RD, SUITE150, TAMPA, FL 33624-2075
(813) 264-1258
(813) 265-2083
Mailing address
5111 EHRLICH RD, SUITE150, TAMPA, FL 33624-2075
(813) 264-1258
(813) 265-2083
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
DN13415
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DN13415
STATE LICENSE NUMBER
FL
Enumeration date
01/25/2007
Last updated
07/08/2007
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