Individual
DR. KEITH VICTOR NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
6183 S PRAIRIE VIEW DR, SUITE 101, SALT LAKE CITY, UT 84129-3203
(801) 968-9147
(801) 966-2932
Mailing address
6183 S PRAIRIE VIEW DR, SUITE 101, SALT LAKE CITY, UT 84129-3203
(801) 968-9147
(801) 966-2932
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
62277
CA
1223G0001X
General Practice Dentistry
Primary
5032263-9922
UT
Other
Enumeration date
11/30/2006
Last updated
04/17/2013
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