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Individual
JUSTIN RAY NELSON
Active
Individual
JUSTIN RAY NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D-5579
ID
122300000X
Dentist
DE61164746
WA
Other
Enumeration date
06/01/2021
Last updated
10/07/2025
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