Organization
NICHOLAS JAMES PENNA D.D.S.,P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NICHOLAS JAMES PENNA D.D.S. (PRESIDENT)
(704) 633-5942
Entity
Organization
Contact information
Practice address
1819 BRENNER AVE, SALISBURY, NC 28144-2519
(704) 633-5942
(704) 639-0237
Mailing address
1819 BRENNER AVE, SALISBURY, NC 28144-2519
(704) 633-5942
(704) 639-0237
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
NC4936
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
899019P
—
NC
05
—
8996806
—
NC
Enumeration date
09/26/2006
Last updated
08/22/2020
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