Organization
BLACK BEAR DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JASON WILLIAM ISAACSON DDS (OWNER/DENTIST)
(715) 609-2461
Entity
Organization
Contact information
Practice address
2901 PIONEER AVE, RICE LAKE, WI 54868-2434
(715) 609-2461
(920) 626-6377
Mailing address
2901 PIONEER AVE, RICE LAKE, WI 54868-2434
(715) 609-2461
(920) 626-6377
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
11/24/2025
Last updated
11/24/2025
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