Individual
JIMMIE D HISSEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2373 W MAIN ST, SALEM, WV 26426-7515
(324) 782-3393
Mailing address
PO BOX 71, SALEM, WV 26426
(324) 752-3393
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2134
WV
Other
Enumeration date
08/31/2006
Last updated
02/26/2016
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