Organization
JASON R. NELSEN DDS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JASON NELSEN DDS (MANAGING MEMBER)
(704) 392-8199
Entity
Organization
Contact information
Practice address
7920 MOORES CHAPEL RD STE A, CHARLOTTE, NC 28214-8924
(704) 392-8199
(704) 392-8441
Mailing address
7920 MOORES CHAPEL RD STE A, CHARLOTTE, NC 28214-8924
(704) 392-8199
(704) 392-8441
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7540
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1780786483
NPI
NC
Enumeration date
03/03/2008
Last updated
03/03/2008
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