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General NPI Number Information
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NPI Number | 1205510393
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Entity Type | Organization
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Legal Business Name | DENTISTRY BY THE NELSONS, PLLC
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Dates
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Enumeration Date | 06/09/2023
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Last Update Date | 06/19/2023
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Provider Practice Location Address
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Address Line | 3190 S GILBERT RD STE 1
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City | CHANDLER
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State | AZ
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Zip | 85286-5106
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Country | US
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Telephone | 602-620-6812
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Fax |
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Provider Business Mailing Address
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Address Line | 4726 E VERBENA DR
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City | PHOENIX
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State | AZ
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Zip | 85044-4974
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Country | US
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Telephone | 602-620-6812
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. BRIAN NELSON
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Credential | DMD
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Telephone | 602-620-6812
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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