Nisco, Philip Matthew

Nisco, Philip Matthew is an sole proprietor health care provider with primary practice located at 17220 Newhope St Ste 227, Fountain Valley CA 92708-4272. He recently has only one registered license in Dental Providers / Orthodontics and Dentofacial Orthopedics, which is considered as his primary health care specialty. Nisco, Philip Matthew can be contacted via phone (714) 979-1400.

Contact Information

Primary practice address
17220 Newhope St Ste 227 Fountain Valley CA 92708-4272
Fax: (714) 979-1403
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Orthodontics and Dentofacial Orthopedics 1223X0400X 032598 California

Profile Details

NPI number 1801019443
LBN Legal business name Nisco, Philip Matthew
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 11th, 2007
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1801019443 NPPES
California Other G92261-01 DENTI-CAL

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