Individual
ELIZABETH FRANCES NISS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS, MS
Contact information
Practice address
20933 DEVONSHIRE ST STE 103, CHATSWORTH, CA 91311-2393
(323) 842-8486
Mailing address
507 N FORMOSA AVE, LOS ANGELES, CA 90036-1944
(323) 842-8486
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
106126
CA
390200000X
Student in an Organized Health Care Education/Training Program
12880
CT
Other
Enumeration date
01/16/2020
Last updated
04/13/2024
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