Individual
DR. JOHNNA LORIE DRISCOLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
2050 M 119, PETOSKEY, MI 49770-8962
(231) 347-7471
(231) 347-7836
Mailing address
2050 M 119, PETOSKEY, MI 49770-8962
(231) 347-7471
(231) 347-7836
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0155960
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D811511
BLUE CROSS BLUE SHIELD
MI
Enumeration date
07/30/2006
Last updated
07/08/2007
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