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Individual

DR. JEREMY KIP NIELSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
10123 LAKE CREEK PKWY, BUILDING 2, AUSTIN, TX 78729-1756
(512) 250-8101
(512) 258-7154
Mailing address
10123 LAKE CREEK PKWY, BUILDING 2, AUSTIN, TX 78729-1756
(512) 250-8101
(512) 258-7154

Taxonomy

Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
25461
TX
1223G0001X
General Practice Dentistry
25461
TX

Other

Enumeration date
06/04/2010
Last updated
01/03/2014
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