Individual
NICHOLAS BIZZARO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
3223 N BROAD ST, PHILADELPHIA, PA 19140-5007
(215) 707-2900
Mailing address
5639 RIDGE AVE, PHILADELPHIA, PA 19128-2765
(215) 896-6524
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS042438
PA
Other
Enumeration date
08/27/2019
Last updated
05/06/2026
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