Individual
DR. JACOB RYAN BISHOP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
13301 SHELBYVILLE RD STE 105, LOUISVILLE, KY 40223-3937
(502) 631-9627
Mailing address
13301 SHELBYVILLE RD STE 105, LOUISVILLE, KY 40223-3937
(502) 599-8996
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
9778
KY
Other
Enumeration date
07/14/2016
Last updated
01/18/2019
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