Individual
DR. NICHOLAS JAMES PENNA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.,P.A.
Contact information
Practice address
1819 BRENNER AVE, SALISBURY, NC 28144-2519
(704) 633-5942
(704) 639-0237
Mailing address
1819 BRENNER AVE, SALISBURY, NC 28144-2519
(704) 633-5942
(704) 639-0237
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
NC4936
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
899019P
—
NC
05
—
8996806
—
NC
Enumeration date
12/19/2006
Last updated
07/09/2007
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