Organization
CHILDREN'S DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK LYMAN NELSON DDS (DENTIST/OWNER)
(801) 295-8322
Entity
Organization
Contact information
Practice address
1551 RENAISSANCE TOWNE DR, STE 540, BOUNTIFUL, UT 84010-7667
(801) 295-8322
Mailing address
1551 RENAISSANCE TOWNE DR, STE 540, BOUNTIFUL, UT 84010-7667
(801) 295-8322
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
141802
UT
Other
Enumeration date
08/20/2015
Last updated
08/20/2015
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