Provider Demographics
NPI:1295797983
Name:BICHARA, JEAN (DDS, MS)
Entity type:Individual
Prefix:DR
First Name:JEAN
Middle Name:
Last Name:BICHARA
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 S. OXFORD VALLEY RD.
Mailing Address - Street 2:
Mailing Address - City:FAIRLESS HILLS
Mailing Address - State:PA
Mailing Address - Zip Code:19030
Mailing Address - Country:US
Mailing Address - Phone:215-269-1430
Mailing Address - Fax:215-269-4622
Practice Address - Street 1:333 S. OXFORD VALLEY RD.
Practice Address - Street 2:
Practice Address - City:FAIRLESS HILLS
Practice Address - State:PA
Practice Address - Zip Code:19030
Practice Address - Country:US
Practice Address - Phone:215-269-1430
Practice Address - Fax:215-269-4622
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ201691223P0300X
PADS028154-L1223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics