Individual
JACQUELINE ISABELLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
8363 CHERRY LN, LAUREL, MD 20707
(301) 245-6711
(301) 490-0402
Mailing address
1403 BERMUDA DUNES CT, BOWIE, MD 20721-3114
(240) 535-3059
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
16668
MD
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/25/2017
Last updated
10/19/2018
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