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Organization
WEST BAY DENTAL PC
Active
Organization
WEST BAY DENTAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH E. NELSON DDS (OWNER/DIRECTOR)
(989) 686-5410
Entity
Organization
Contact information
Practice address
401 S EUCLID AVE, BAY CITY, MI 48706-3205
(989) 686-5410
(989) 686-7340
Mailing address
401 S EUCLID AVE, BAY CITY, MI 48706-3205
(989) 686-5410
(989) 686-7340
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
11981
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
800527
BCBSM PROVIDER NUMBER
MI
01
—
817452
UCCI PROVIDER NUMBER
MI
Enumeration date
01/09/2006
Last updated
11/08/2011
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