Organization
BRUCE L. NELSON, DDS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRUCE L NELSON D.D.S. (PRESIDENT)
(602) 678-4500
Entity
Organization
Contact information
Practice address
1776 E GLENDALE AVE, PHOENIX, AZ 85020-5505
(620) 678-4500
Mailing address
1776 E GLENDALE AVE, PHOENIX, AZ 85020-5505
(620) 678-4500
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2293
AZ
Other
Enumeration date
03/07/2007
Last updated
11/20/2007
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