OrganizationActive
Innovative Implant & Oral Surgery PC
NPI 1679547707 · Oral & Maxillofacial Surgery (D.M.D.) · Feasterville Trevose, PA
Provider details
- NPI number
- 1679547707
- Entity type
- Organization
- Primary specialty
- Oral & Maxillofacial Surgery (D.M.D.)Allopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Debra Lodise, Office Manager(215) 322-7810
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Customized Equipment (DME)332BC3200X
Suppliers
Practice location
1300 Bridgetown Pike
Feasterville Trevose, PA 19053-4326
Phone: (215) 322-7810
Fax: (215) 322-7832
Approximate (ZIP-level) locationGet directions
Mailing address
1300 Bridgetown Pike
Feasterville Trevose, PA 19053-4326
Other names (DBA / former)
- Former legal business name
- Charles B Nissman DDS
- Former legal business name
- Charles B Nissman DDS
- Former legal business name
- Nissman-Salin Oral & Maxillofacial Surgery PC
Additional practice locations (2)
- 1494 Old York Rd Fl 2Abington, PA 19001-2614Phone: (215) 322-7810Fax: (215) 322-7832
- 638 Newtown Yardley Rd Ste 2aNewtown, PA 18940-1739Phone: (215) 322-7810Fax: (215) 322-7832
Registry dates
- Enumerated
- 2006-02-15
- Last updated
- 2026-01-23
- Certified
- 2026-01-23
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.