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General NPI Number Information
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NPI Number | 1841743499
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Entity Type | Organization
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Legal Business Name | NELSON & NELSON, DDS PLC
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Dates
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Enumeration Date | 08/01/2016
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Last Update Date | 08/01/2016
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Provider Practice Location Address
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Address Line | 9132 S MASON DR
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City | NEWAYGO
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State | MI
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Zip | 49337-7920
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Country | US
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Telephone | 231-250-5003
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 935
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City | NEWAYGO
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State | MI
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Zip | 49337-0935
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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. ROSS R NELSON
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Credential | DDS
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Telephone | 231-250-5003
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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 | 2901011845
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License Number State | MI
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