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Individual

DR. GIRARD THOMAS NISTA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
89 PORTSMOUTH AVE, STRATHAM, NH 03885-2467
(603) 778-8181
(603) 772-4942
Mailing address
89 PORTSMOUTH AVE, STRATHAM, NH 03885-2467
(603) 778-8181
(603) 772-4942

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
1030
NH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1030
STATE LICENSE
NH
Enumeration date
05/25/2007
Last updated
07/08/2007
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