Individual
DR. ABISOLA JEGEDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD, MPH
Contact information
Practice address
919 E JEFFERSON BLVD STE 100, SOUTH BEND, IN 46617-3112
(574) 245-7504
Mailing address
3411 NELSON RD STE 100, LAKE CHARLES, LA 70605-1240
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
7109
LA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
12014860A
IN
Other
Enumeration date
06/25/2020
Last updated
08/20/2025
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