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Organization

GARY S NELSON DMD INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
GARY S NELSON DMD (PRESIDENT)
(703) 777-7307
Entity
Organization

Contact information

Practice address
21 FORT EVANS RD NE STE E, LEESBURG, VA 20176-4488
(703) 777-7307
(703) 777-7840
Mailing address
21 FORT EVANS RD NE STE E, LEESBURG, VA 20176-4488
(703) 777-7307
(703) 777-7840

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401007110
VA

Other

Enumeration date
08/24/2006
Last updated
07/01/2011
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