Individual
DON NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S. , M.S.D.
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
1954
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1954
MT. STATE BOARD
MT
05
—
2210068
—
MT
01
—
D-3081
IDAHO STATE BOARD
ID
01
—
DE00004115
WA STATE BOARD
WA
Enumeration date
09/22/2006
Last updated
01/31/2013
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