Provider Demographics
NPI:1093856858
Name:BISHOP, JAMES E (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:E
Last Name:BISHOP
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:850 36TH AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:MOLINE
Mailing Address - State:IL
Mailing Address - Zip Code:61265-7169
Mailing Address - Country:US
Mailing Address - Phone:309-762-5566
Mailing Address - Fax:309-762-7032
Practice Address - Street 1:850 36TH AVE
Practice Address - Street 2:SUITE B
Practice Address - City:MOLINE
Practice Address - State:IL
Practice Address - Zip Code:61265-7169
Practice Address - Country:US
Practice Address - Phone:309-762-5566
Practice Address - Fax:309-762-7032
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice