Individual
JASON S BISHOP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
85 SIERRA PARK RD, MAMMOTH LAKES, CA 93546-2073
(760) 924-4007
(760) 924-4048
Mailing address
1680 N COAST HIGHWAY 101 UNIT 47, ENCINITAS, CA 92024-1050
(760) 710-1369
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
43758
CA
Other
Enumeration date
11/06/2006
Last updated
06/16/2016
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