Organization
THE NELSON DENTAL PRACTICE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES HOWELL NELSON III DDS (DENTIST)
(703) 361-2141
Entity
Organization
Contact information
Practice address
9216 CENTREVILLE RD, MANASSAS, VA 20110-5131
(703) 361-2141
(703) 393-7391
Mailing address
9216 CENTREVILLE RD, MANASSAS, VA 20110-5131
(703) 361-2141
(703) 393-7391
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
—
—
332BC3200X
Customized Equipment (DME)
Primary
0401007907
VA
Other
Enumeration date
07/28/2006
Last updated
03/01/2017
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