Individual
JESSICA JOHN BRISBOIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
20136 MACK AVE, GROSSE POINTE WOODS, MI 48236-1820
(313) 886-9355
Mailing address
20136 MACK AVE, GROSSE POINTE WOODS, MI 48236-1820
(313) 886-9355
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901021562
MI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/21/2015
Last updated
10/01/2021
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