Individual
JONATHAN BISHOP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
982 MAIN ST, WALTHAM, MA 02451-7404
(781) 899-5660
Mailing address
982 MAIN ST, WALTHAM, MA 02451-7404
(781) 899-5660
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DN1857260
MA
Other
Enumeration date
04/16/2016
Last updated
10/16/2024
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