NPI 1013427509

Ldshane PLLC

Organisation Dentist Jacksonville, FL

Practice location

Address: 1566 Dunn Ave, Jacksonville, FL 32218
Phone: (904) 751-4958
Fax: (904) 751-5330

Authorised official

Name: Ryan Johnson
Title: Owner
Phone: (904) 751-4958

Registered specialties

Dentist Primary

Dental Providers Taxonomy 122300000X

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Registry record

NPI: 1013427509
Entity type: Organization
NPI issued: 10 Oct 2017
Record last updated: 10 Oct 2017

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.