Individual
TASHIBA I NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.M.D
Contact information
Practice address
60 CENTER ST, WINDSOR, CT 06095-1402
(860) 255-4197
Mailing address
60 CENTER ST, WINDSOR, CT 06095-1402
(860) 255-4197
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
LNO6123
AL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/18/2013
Last updated
04/13/2015
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