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Organization
BRENT E. NELSEN DMD, LLC
Active
Organization
BRENT E. NELSEN DMD, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRENT EDWARD NELSEN DMD (OWNER)
(316) 789-9999
Entity
Organization
Contact information
Practice address
1120 N ROCK RD, DERBY, KS 67037-3584
(316) 789-9999
(316) 789-9296
Mailing address
1120 N ROCK RD, DERBY, KS 67037-3584
(316) 789-9999
(316) 789-9296
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
7193
KS
Other
Enumeration date
10/22/2014
Last updated
10/22/2014
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