# TIMOTHY E NELSON DDS PS

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

## Provider details

- **NPI number:** 1821027913
- **Authorized official:** TIMOTHY E NELSON DDS (CORPORATION OFFICER)
- **Authorized official phone:** (360) 425-7220

## Contact information

- **Practice address:** 855 11TH AVE, SUITE B, LONGVIEW, WA 98632-2461
- **Practice address phone:** (360) 425-7220
- **Practice address fax:** (360) 425-5045
- **Mailing address:** 855 11TH AVE, SUITE B, LONGVIEW, WA 98632-2461
- **Mailing address phone:** (360) 425-7220
- **Mailing address fax:** (360) 425-5045

## Taxonomy

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

## Other

- **Enumeration date:** 07/01/2006
- **Last updated:** 02/03/2015