Individual
DR. DANE NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
2410 SAMPSON ST, CAPTAIN JAMES A. LOVELL FEDERAL HEALTH CARE CENTER, GREAT LAKES, IL 60088-2942
(651) 226-3562
Mailing address
1575 OAK AVE APT 12, EVANSTON, IL 60201-4249
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D13673
MN
Other
Enumeration date
06/06/2016
Last updated
06/06/2016
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