Individual
ROBERT L NISSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S., M.S.D.
Contact information
Practice address
3210 ROYAL DR, CAMERON PARK, CA 95682-8506
(530) 677-1769
(530) 677-1680
Mailing address
3210 ROYAL DRIVE, CAMERON PARK, CA 95682-8506
(530) 677-1769
(530) 677-1680
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
34749
CA
Other
Enumeration date
09/02/2009
Last updated
09/02/2009
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