Individual
DR. ORISSA NITIBHON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
460 CRESCENT ST, MENOMONIE, WI 54751-1827
(715) 972-9975
Mailing address
1260 MILTON AVE, JANESVILLE, WI 53545-1889
(608) 757-0057
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6001518-15
WI
Other
Enumeration date
11/29/2023
Last updated
01/23/2025
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