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Organization

NELSON FAMILY DENTAL, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JOHN H. NELSON D.D.S. (PARTNER)
(507) 433-9515
Entity
Organization

Contact information

Practice address
205 6TH PL NW, AUSTIN, MN 55912-3025
(507) 433-9515
(507) 434-0254
Mailing address
205 6TH PL NW, AUSTIN, MN 55912-3025
(507) 433-9515
(507) 434-0254

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7583
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1035
HEALTH PARTNERS IDENTIFIE
MN
01
124L8NE
BCBS IDENTIFIER
MN
Enumeration date
10/13/2005
Last updated
08/22/2020
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