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Contact Information

MONICA L CLISSO, DDS
807 PARK AVE NE
NORTON, VA24273
 Phone: 276-679-6030
 Fax: 276-679-6030
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
Indicates primary specialty

NPI Profile & details for MONICA L CLISSO · (Female)

NPI # 1649429036
Status Active
Credentials DDS (Doctor of Dental Surgery)
Entity Individual
Enumeration date 09/10/2008
Last updated 09/10/2008 - About 18 years ago
Sole proprietor 1 No
Identifiers
  • VA License # 0401410603
  • VA Medicaid 9178672
  • VA Other 197242 BLUE CROSS ANTHEM
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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