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General NPI Number Information
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NPI Number | 1649707696
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Entity Type | Organization
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Legal Business Name | WESLEY NELSON, DDS PA
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Dates
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Enumeration Date | 05/20/2017
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Last Update Date | 06/27/2018
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Provider Practice Location Address
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Address Line | 5770 WILES RD
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City | CORAL SPRINGS
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State | FL
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Zip | 33067
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Country | US
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Telephone | 954-255-5166
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Fax |
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Provider Business Mailing Address
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Address Line | 5770 WILES RD
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City | CORAL SPRINGS
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State | FL
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Zip | 33067-2156
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | DR. WESLEY NELSON
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Credential | DDS
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Telephone | 201-674-3878
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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 | DN21633
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License Number State | FL
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