Individual provider · Type 1 NPI
Larry Wayne Nissen, DDS
Oral and Maxillofacial Surgery (Dentist) · Merritt Island, FL
Practice location
280 N Sykes Creek Pkwy, Suite C
Merritt Island, FL 32953-3491
Fax (321) 452-2125
Mailing address
280 N Sykes Creek Pkwy Ste C
Merritt Island, FL 32953-3491
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Oral and Maxillofacial Surgery (Dentist) Primary | 1223S0112X | 7315 (FL) |
Oral and Maxillofacial Surgery (Dentist): The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
6 other providers at this address
- Frank X Venzara MdpaLegal Medicine Merritt Island, FL NPI 1013182880
- Frank X. Venzara, MDPlastic Surgery Physician Merritt Island, FL NPI 1356451306
- Frank Xavier Venzara Iii, MDOphthalmology Physician Merritt Island, FL NPI 1992965214
- Richard D. Koenig, DPMFoot & Ankle Surgery Podiatrist Merritt Island, FL NPI 1881739258
- Robert L. Bashore, MDPlastic Surgery Physician Merritt Island, FL NPI 1154431195
- Robert Stanley Patt Ii, CRNACertified Registered Nurse Anesthetist Merritt Island, FL NPI 1528206422
About NPI 1386777183
Larry Wayne Nissen, DDS's National Provider Identifier is 1386777183, issued on Mar 13, 2007. The primary taxonomy on file is Oral and Maxillofacial Surgery (Dentist) (1223S0112X), and the practice location is in Merritt Island, FL. The record was last updated on Jul 8, 2007.