Organization
NICOLLET DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CASEY LEE NELSON D.D.S. (OWNER)
(612) 866-8550
Entity
Organization
Contact information
Practice address
6101 NICOLLET AVE. SO., MINNEAPOLIS, MN 55419
(612) 866-8550
(612) 866-9453
Mailing address
6101 NICOLLET AVE. SO., MINNEAPOLIS, MN 55419
(612) 866-8550
(612) 866-9453
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D12104
MN
Other
Enumeration date
05/11/2011
Last updated
05/11/2011
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