MEDICARE: FRANCE NIELSON DDS PLLC

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

General Provider Information

NPI Number	:	1912549593
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FRANCE NIELSON DDS PLLC

Provider Business Mailing Address
First Line	:	8475 GREAT OUTDOORS ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89166-3814
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6170 N DURANGO DR STE 110
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89149-3923
Country	:	US
Telephone Number	:	801-592-9543
Fax Number	:

Authorized Official
Title or Position	:	OWNER/DENTIST
Name	:	DR. FRANCE NIELSON
Credential	:	DDS
Telephone Number	:	801-592-9543

Provider Enumeration Date	:	10/15/2019
Last Update Date	:	10/15/2019

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