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NPI Code Detail

MEDICARE: DR. ANTHONY RAY NELSON GENERAL DENTIST

MEDICARE:  DR. ANTHONY RAY NELSON  GENERAL DENTIST
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 Dentistry3444LA

General Provider Information

NPI Number : 1932359304
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ANTHONY RAY NELSON GENERAL DENTIST
Provider Business Mailing Address
First Line : 1413 S 2ND ST
Second Line :
City : MONROE
State : LA
Zip : 71202-2739
Country : US
Telephone Number : 318-323-3162
Fax Number :
Provider Business Practice Location Address
First Line : 1413 S 2ND ST
Second Line :
City : MONROE
State : LA
Zip : 71202-2739
Country : US
Telephone Number : 318-323-3162
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/23/2008
Last Update Date : 09/23/2008

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Directions to “ DR. ANTHONY RAY NELSON GENERAL DENTIST” Practice Location

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