# PETER S. NELSON, DDS, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1760845978
- **Authorized official:** PETER S NELSON DDS (OWNER)
- **Authorized official phone:** (602) 938-0880

## Contact information

- **Practice address:** 5750 W THUNDERBIRD RD, H850, GLENDALE, AZ 85306-4660
- **Practice address phone:** (602) 938-0880
- **Practice address fax:** (602) 547-0528
- **Mailing address:** 5750 W THUNDERBIRD RD, H850, GLENDALE, AZ 85306-4660
- **Mailing address phone:** (602) 938-0880
- **Mailing address fax:** (602) 547-0528

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | D009095 | AZ | Yes |

## Other

- **Enumeration date:** 04/04/2016
- **Last updated:** 04/04/2016