Individual
MARK ANDREW NISTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
105 PFEFFER RD, SUITE 2, EXPORT, PA 15632-1934
(724) 733-3766
(724) 325-8058
Mailing address
105 PFEFFER RD, SUITE 2, EXPORT, PA 15632-1934
(724) 733-3766
(724) 325-8058
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS-030346L
PA
Other
Enumeration date
10/02/2006
Last updated
07/08/2007
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