LARRY WAYNE NISSEN

MERRITT ISLAND, FL
NPI1386777183
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1223S0112X Dentist, Oral and Maxillofacial Surgery
(Licence: FL  7315)
Enumeration Date2007-03-13
Last Update Date2007-07-08
Business Address
Dr. LARRY WAYNE NISSEN DDS
280 N SYKES CREEK PKWY SUITE C
MERRITT ISLAND, FL 32953-3491
Phone number: 321-452-5500
Mailing Address
Dr. LARRY WAYNE NISSEN DDS
280 N SYKES CREEK PKWY STE C
MERRITT ISLAND, FL 32953-3491
Phone number: 321-452-5500
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