Individual
JENS DEAN NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D
Contact information
Practice address
101 BODIN CIR, TRAVIS, AFB, CA 94535
(707) 423-7008
Mailing address
101 BODIN CIR, TRAVIS AFB, CA 94535-1800
(801) 368-3999
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
8715229-9922
UT
1223P0700X
Prosthodontics
Primary
8715229-9922
UT
Other
Enumeration date
06/03/2013
Last updated
08/05/2021
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