Individual
JUSTIN RAY NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
103 W SUPERIOR ST, SANDPOINT, ID 83864-1601
(208) 263-8514
Mailing address
103 W SUPERIOR ST, SANDPOINT, ID 83864-1601
(208) 263-8514
(208) 844-2962
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D-5579
ID
122300000X
Dentist
DE61164746
WA
Other
Enumeration date
06/01/2021
Last updated
10/07/2025
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