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Individual
DR. MARK L NELSON
Active
Individual
DR. MARK L NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
141802
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
562460
UNITED CONCORDIA
UT
01
—
870542081
TAX ID FOR MISC INSURANCE
UT
Enumeration date
03/27/2006
Last updated
07/13/2026
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