Organization
CRAIG L NELSON DDS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CRAIG L NELSON DDS (PRESIDENT)
(260) 463-3123
Entity
Organization
Contact information
Practice address
405 UNION STREET, LAGRANGE, IN 46761
(260) 463-3123
Mailing address
405 UNION STREET, LAGRANGE, IN 46761
(260) 463-3123
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12006413A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100159780
—
IN
Enumeration date
06/15/2006
Last updated
06/04/2014
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