Individual
DR. JEDIDIAH L.G. JANISSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
367 ROUTE 120, LEBANON, NH 03766-1430
(973) 296-5022
Mailing address
367 ROUTE 120, LEBANON, NH 03766-1430
(973) 296-5022
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
03932
NH
1223G0001X
General Practice Dentistry
016-0002247
VT
Other
Enumeration date
06/20/2007
Last updated
03/09/2015
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