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Individual

DR. MATTHEW EDGAR NELSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S

Contact information

Practice address
7101 HOFF STREET, BUILDING 9240 LOVE DENTAL CLINIC, FORT BENNING, GA 31905
(269) 326-0065
Mailing address
5200 GREYSTONE SUMMIT DR APT 1008, COLUMBUS, GA 31909-7556
(269) 326-0065

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6736-15
WI

Other

Enumeration date
04/27/2011
Last updated
06/23/2011
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