Individual
RONI NISSAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
3535 WELSH RD, WILLOW GROVE, PA 19090-3857
(215) 657-3770
(215) 657-3934
Mailing address
3535 WELSH RD, WILLOW GROVE, PA 19090-3857
(215) 657-3770
(215) 657-3934
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS02813L
PA
Other
Enumeration date
05/07/2007
Last updated
07/08/2007
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