Nissenbaum, Mark

Nissenbaum, Mark is an individual health care provider with primary practice located at 200 Boylston St Suite 305, Chestnut Hill MA 02467-2012. He recently has only one registered license in Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery, which is considered as his primary health care specialty. Nissenbaum, Mark can be contacted via phone (617) 731-8888.

Contact Information

Primary practice address
200 Boylston St Suite 305 Chestnut Hill MA 02467-2012
Phone: (617) 731-8888
Fax: (617) 731-3107
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery 204E00000X 8460 Massachusetts

Profile Details

NPI number 1902897184
LBN Legal business name Nissenbaum, Mark
Credentials DMD MDC FCDSA OMFS
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 4th, 2005
Last updated Feb 27th, 2014 - about 11 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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