Individual
JUSTIN BISHOP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D
Contact information
Practice address
431 JOHNSTON ST SE, DECATUR, AL 35601-3007
(256) 355-1744
Mailing address
208 MAIGOLD CIR., MADISON, AL 35758
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6413
AL
Other
Enumeration date
05/01/2017
Last updated
03/15/2018
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