Individual
DR. MICHAEL FREDERIC NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
3190 NORTH ST, BEAUMONT, TX 77702-1420
(099) 924-0002
Mailing address
3190 NORTH ST, BEAUMONT, TX 77702-1420
(099) 924-0002
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
48751
CA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
26028
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0
DO NOT HAVE
—
Enumeration date
07/26/2006
Last updated
01/11/2021
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