# ROBERT L NELSON DDS MOBILE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** KC MOBILE DENTAL
- **Organization subpart:** No

## Provider details

- **NPI number:** 1245698778
- **Authorized official:** MR. CHARLES R CRUTCHFIELD (MANAGER)
- **Authorized official phone:** (816) 807-7092

## Contact information

- **Practice address:** 9608 W 123RD ST, OVERLAND PARK, KS 66213-1689
- **Practice address phone:** (816) 707-7092
- **Practice address fax:** (913) 273-4712
- **Mailing address:** 9608 W 123RD ST, OVERLAND PARK, KS 66213-1689
- **Mailing address phone:** (816) 707-7092
- **Mailing address fax:** (913) 273-4712

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | 5212 | KS | Yes |

## Other

- **Enumeration date:** 01/28/2016
- **Last updated:** 01/29/2016