Healthcare Provider Details

I. General information

NPI: 1083679278
Provider Name (Legal Business Name): STEVEN R NELSON D.D.S., M.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2006
Last Update Date: 07/12/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6850 E HAMPDEN AVE
DENVER CO
80224-3024
US

IV. Provider business mailing address

6850 E HAMPDEN AVE
DENVER CO
80224-3024
US

V. Phone/Fax

Practice location:
  • Phone: 303-758-6850
  • Fax: 303-758-0729
Mailing address:
  • Phone: 303-758-6850
  • Fax: 303-758-0729

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number6819
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: