Organization
VAN ALSTYNE DENTAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES NIELSEN (OWNER)
(903) 712-4440
Entity
Organization
Contact information
Practice address
1286 W VAN ALSTYNE PKWY, VAN ALSTYNE, TX 75495-4390
(903) 712-4440
Mailing address
1286 W VAN ALSTYNE PKWY, VAN ALSTYNE, TX 75495-4390
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
1223G0001X
TX
Other
Enumeration date
06/15/2011
Last updated
06/15/2011
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