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General NPI Number Information
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NPI Number | 1104393826
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Entity Type | Organization
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Legal Business Name | NELSON J. MAR DDS PC
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Dates
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Enumeration Date | 10/31/2018
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Last Update Date | 10/31/2018
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Provider Practice Location Address
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Address Line | 5220 N. DYSART RD #144
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City | LITCHFIELD PARK
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State | AZ
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Zip | 85340
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Country | US
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Telephone | 623-536-6845
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Fax | 623-536-7989
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Provider Business Mailing Address
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Address Line | 5220 N. DYSART RD. #144
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City | LITCHFIELD PARK
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State | AZ
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Zip | 85340
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Country | US
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Telephone | 623-536-6845
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Fax | 623-536-7989
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Authorized Official
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Title or Position | DOCTOR
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Name | MR. NELSON J. MAR
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Credential | D.D.S., P.C.
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Telephone | 623-536-6845
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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