Individual
DR. JACOB JOSEPH BISSONETTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
7777 U.S. RT. 23, PIKETON, OH 45661
(740) 289-3508
Mailing address
7777 U.S. RT. 23, PIKETON, OH 45661
(740) 289-3508
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
30022616
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2783715
—
OH
Enumeration date
10/22/2007
Last updated
12/10/2008
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