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Organization
PETER C. NELSON DDS, INC.
Active
Organization
PETER C. NELSON DDS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PETER C. NELSON D.D.S. (OWNER)
(805) 544-1877
Entity
Organization
Contact information
Practice address
1250 PEACH ST STE L, SAN LUIS OBISPO, CA 93401-2875
(805) 544-1877
(805) 544-9026
Mailing address
1250 PEACH ST STE L, SAN LUIS OBISPO, CA 93401-2875
(805) 544-1877
(805) 544-9026
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
21276
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
B21276
MEDICAL
CA
Enumeration date
08/13/2007
Last updated
09/18/2007
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