Individual
JOHN JENISTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
6000 W HIGHWAY 98, PENSACOLA, FL 32512-0001
(850) 452-5638
Mailing address
554 KEILY STREET, BUREAU OF MEDICINE AND SURGERY - CREDENTIALS & PRIVILEG, JACKSONVILLE, FL 32212
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN 20881
FL
Other
Enumeration date
08/14/2014
Last updated
05/29/2024
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