Organization
BRENT E. NELSEN DMD, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRENT EDWARD NELSEN DMD (OWNER)
(316) 789-9999
Entity
Organization
Contact information
Practice address
1120 N ROCK RD, DERBY, KS 67037-3584
(316) 789-9999
(316) 789-9296
Mailing address
1120 N ROCK RD, DERBY, KS 67037-3584
(316) 789-9999
(316) 789-9296
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
7193
KS
Other
Enumeration date
10/22/2014
Last updated
10/22/2014
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