Individual
DR. JOHN SAMUEL NIZIC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
60 NW 2ND ST, GRESHAM, OR 97030-7222
(503) 665-3116
(503) 665-3563
Mailing address
60 NW 2ND ST, GRESHAM, OR 97030-7222
(503) 665-3116
(503) 665-3563
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4650
OR
Other
Enumeration date
08/29/2006
Last updated
07/08/2007
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