Individual
RONALD NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2050A SECOND STREET SE, KIRTLAND AFB, NM 87117-5522
(505) 846-2607
Mailing address
2050A SECOND STREET SE, KIRTLAND AFB, NM 87117-5522
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D3164
AZ
Other
Enumeration date
02/09/2006
Last updated
09/23/2008
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