Individual
ANNA ELIZABETH NISSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
4328 OLD WILLIAM PENN HWY, MONROEVILLE, PA 15146-1496
(412) 373-7777
Mailing address
107 W 1ST AVE, COLUMBUS, OH 43201-3403
(419) 704-4089
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS042177
PA
Other
Enumeration date
06/03/2019
Last updated
06/03/2019
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