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Individual

DR. BLAKE PATRICK NELSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
3066 TRENWEST DR, WINSTON SALEM, NC 27103-3208
(828) 455-0952
Mailing address
3066 TRENWEST DR, WINSTON SALEM, NC 27103-3208
(828) 455-0952

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
10894
NC
1223G0001X
General Practice Dentistry
30.025179
OH

Other

Enumeration date
07/29/2016
Last updated
07/21/2022
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