DR. Larry Lee Nillissen, DDS
NPI #1518121284 in Birnamwood, Wisconsin
Provider Information
- NPI Number
- 1518121284
- Entity Type
- Individual
- Name
- DR. Larry Lee Nillissen, DDS
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Dentist
- Credential
- DDS
- Enumeration Date
- Jul 11, 2008
- Last Updated
- Jul 11, 2008
Practice Location
- Address
- 409A MAIN ST
- City
- Birnamwood
- State
- Wisconsin
- ZIP Code
- 54414-0206
- Phone
- (715) 449-3345
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist |
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