Individual
NICOLE T NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
5805 MANDERSON ST, OMAHA, NE 68104-2939
(480) 599-6412
Mailing address
5805 MANDERSON ST, OMAHA, NE 68104-2939
(480) 599-6412
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7438
NE
Other
Enumeration date
02/28/2018
Last updated
02/28/2018
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