Organization
RSS GARY NELSON LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SARA BROWN (DIRECTOR)
(817) 440-6060
Entity
Organization
Contact information
Practice address
11912 JONES BRIDGE RD STE B, ALPHARETTA, GA 30005-4613
(844) 859-2525
Mailing address
1050 TEXAN TRL STE 300, GRAPEVINE, TX 76051-3759
(817) 440-6060
(469) 533-0476
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
261QS1200X
Sleep Disorder Diagnostic Clinic/Center
—
—
Other
Enumeration date
10/26/2017
Last updated
10/26/2017
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