Individual
NICHOLAS GILBERT PERSICKETTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
212 N WHITE HORSE PIKE, STRATFORD, NJ 08084-1224
(856) 784-1540
Mailing address
212 N WHITE HORSE PIKE, STRATFORD, NJ 08084-1224
(856) 784-1540
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
22DI02722100
NJ
Other
Enumeration date
09/10/2018
Last updated
09/10/2018
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