Jedidiah L Janisse Dmd and Associates, Ltd

NPI #1083850374 in Woodstock, Vermont

Provider Information

NPI Number: 1083850374
Entity Type: Organization
Organization Name: Jedidiah L Janisse Dmd and Associates, Ltd
Primary Specialty: Clinic/Center - Oral and Maxillofacial Surgery
Enumeration Date: Dec 17, 2008
Last Updated: Oct 11, 2019

Practice Location

Address: 217 MAXHAM MEADOW WAY # 10
Address 2: SUITE 4C
City: Woodstock
State: Vermont
ZIP Code: 05091-1162
Phone: (802) 457-1903

Authorized Official

Name: DR. JEDIDIAH L JANISSE, DMD
Title: PRESIDENT
Phone: (802) 457-1903

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X
Clinic/Center - Oral and Maxillofacial Surgery — Oral and Maxillofacial Surgery	261QS0112X	Primary

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