Individual
GREGORY NIELSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
315 BOSTON RD, NORTH BILLERICA, MA 01862-2635
(978) 391-6783
Mailing address
1215 LEE ST # 800740, CHARLOTTESVILLE, VA 22908-0816
(434) 924-1774
(434) 243-6378
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DN1859444
MA
1223G0001X
General Practice Dentistry
Primary
DN1859444
MA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/31/2020
Last updated
10/06/2022
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