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Individual

DR. JOHN EDWARD BISSELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.D.S., M.S.

Contact information

Practice address
8405 W FOREST HOME AVE, GREENFIELD, WI 53228-3407
(414) 425-7710
(414) 425-7424
Mailing address
634 RIVERWOOD LN, WEST BEND, WI 53095-4395
(262) 334-2881

Taxonomy

Speciality
Code
Description
License number
State
1223P0300X
Periodontics
07983
IA
1223P0300X
Periodontics
Primary
6021-015
WI

Other

Enumeration date
12/18/2005
Last updated
07/08/2007
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