Individual
KEVIN P NIELSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
719 SLEATER KINNEY RD SE STE 130, LACEY, WA 98503-1138
(360) 455-1231
(360) 455-1231
Mailing address
719 SLEATER KINNEY RD SE STE 130, LACEY, WA 98503-1138
(360) 455-1231
(360) 455-1231
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DE60089787
WA
Other
Enumeration date
08/27/2009
Last updated
08/27/2009
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