| Louis J Russo Jr Jonathan L Nicozisis Dmd Ms Pa | |
|
601 Ewing St B 12 Princeton NJ 08540-2757 | |
| (609) 924-3271 | |
| Not Available |
| Full Name | Louis J Russo Jr Jonathan L Nicozisis Dmd Ms Pa |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 601 Ewing St, Princeton, New Jersey |
| Authorized Official Name and Position | Jonathan Louis Nicozisis (PARTNER, OWNER) |
| Authorized Official Contact | 6099243271 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Louis J Russo Jr Jonathan L Nicozisis Dmd Ms Pa 601 Ewing St B 12 Princeton NJ 08540-2757 Ph: (609) 924-3271 | Louis J Russo Jr Jonathan L Nicozisis Dmd Ms Pa 601 Ewing St B 12 Princeton NJ 08540-2757 Ph: (609) 924-3271 |
| NPI Number | 1942425137 |
|---|---|
| Provider Enumeration Date | 04/15/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942425137 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | DI 20775 (New Jersey) | Primary |
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