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NPI Code Detail

MEDICARE: DR. JAMES EDWARD NELSON DDS

MEDICARE: DR. JAMES EDWARD NELSON DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry1132MT

General Provider Information

NPI Number : 1144359464
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JAMES EDWARD NELSON DDS
Provider Business Mailing Address
First Line : 114 13TH ST S
Second Line :
City : GREAT FALLS
State : MT
Zip : 59401-3816
Country : US
Telephone Number : 406-454-3711
Fax Number : 406-454-3715
Provider Business Practice Location Address
First Line : 114 13TH ST S
Second Line :
City : GREAT FALLS
State : MT
Zip : 59401-3816
Country : US
Telephone Number : 406-454-3711
Fax Number : 406-454-3715
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/04/2007
Last Update Date : 07/08/2007

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