Individual
DR. MICHAEL D NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
412 W MAIN ST, GRANGEVILLE, ID 83530-1447
(208) 983-2422
(208) 983-3404
Mailing address
412 W MAIN ST, GRANGEVILLE, ID 83530-1447
(208) 983-2422
(208) 983-3404
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
55899
CA
122300000X
Dentist
Primary
D-4201
ID
Other
Enumeration date
10/26/2007
Last updated
02/18/2009
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