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Organization
PAVEL NISS DENTAL CORPORATION
Active
Organization
PAVEL NISS DENTAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAVEL NISS DDS (PRESIDENT)
(323) 683-2668
Entity
Organization
Contact information
Practice address
9050 SEPULVEDA BLVD, NORTH HILLS, CA 91343-4308
(323) 683-2668
Mailing address
6331 RHEA AVE, TARZANA, CA 91335-6834
(323) 683-2668
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
10/05/2018
Last updated
10/05/2018
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