Organization
BRADLEY J. NELSON D.D.S. P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRADLEY J NELSON GENERAL DENTIST (DENTIST)
(651) 439-4115
Entity
Organization
Contact information
Practice address
363 5TH AVE N, BAYPORT, MN 55003-1232
(651) 439-4115
Mailing address
363 5TH AVE N, BAYPORT, MN 55003-1232
(651) 439-4115
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
9832
MN
Other
Enumeration date
05/02/2007
Last updated
08/22/2020
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