NPI | 1073561213 |
---|---|
Professional Name | JOHN MCKISSOCK |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: CO 9878) |
Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: FL DN 16025) |
Enumeration Date | 2006-05-04 |
Last Update Date | 2022-05-16 |