Individual
MARK ALEXANDER NIZZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD, MD
Contact information
Practice address
4607 LEAP CT, HILLIARD, OH 43026-1174
(614) 885-3339
Mailing address
3367 DOUGLAS RD, SOUTH BEND, IN 46635-1779
(574) 272-8823
(574) 277-1837
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
30.025947
OH
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
12013970A
IN
Other
Enumeration date
05/09/2018
Last updated
10/09/2025
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