Shannon Nissen DDS, MS

NPI 1134423965 - Dentist - 1223X0400X

NPI Details
NPI 1134423965
Gender Female
Enumeration Date 01/10/2011
Last Updated 01/10/2011
Entity Type Individual
Active Over 5 years ago
Practice Location
26302 LA PAZ RD STE 202
MISSION VIEJO CA, 92691-5328, US
Phone (848) 830-4101
Fax
Business Location
26302 LA PAZ RD STE 202
MISSION VIEJO CA, 92691-5328, US
Phone (848) 830-4101
Fax
Toxanomy
Taxonomy Code 1223X0400X
License State California
License Number 56349
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According to our database, Dr. Shannon Nissen DDS, MS NPI is 1134423965, taxonomy code is 1223X0400X and license number is 56349, license state is located at California. Shannon Nissen DDS, MS physically located at 26302 La Paz Rd Ste 202, Mission Viejo CA, 92691-5328. NPI Number Shannon Nissen DDS, MS has the Individual type.

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1134423965 NPI number is provided on an as is basis without warranty of any kind. 1134423965 is maintained by the National Plan & Provider Enumeration System. The contents of Shannon Nissen DDS, MS are for informational purposes only.