Individual
DONNA NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1095 NAUTICA LN, PAINESVILLE, OH 44077-7908
(203) 857-9481
Mailing address
1095 NAUTICA LN, PAINESVILLE, OH 44077-7908
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
MK979776
OH
Other
Enumeration date
10/11/2021
Last updated
10/11/2021
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