MEDICARE: DR. SHARON L. NELSON D.D.S

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
1	1223G0001X	General Practice Dentistry	6468	MD

General Provider Information

NPI Number	:	1144526245
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHARON L. NELSON D.D.S

Provider Business Mailing Address
First Line	:	8325 GUILFORD ROAD SUITE G
Second Line	:
City	:	COLUMBIA
State	:	MD
Zip	:	21046
Country	:	US
Telephone Number	:	410-381-0994
Fax Number	:

Provider Business Practice Location Address
First Line	:	8325 GUILFORD RD STE G
Second Line	:
City	:	COLUMBIA
State	:	MD
Zip	:	21046-2816
Country	:	US
Telephone Number	:	410-381-0994
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/07/2011
Last Update Date	:	02/07/2011

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