Individual
JACQUELINE ANN NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
801 E CHAPMAN AVE STE 226, FULLERTON, CA 92831-3847
(714) 680-9500
Mailing address
4523 E WHITE DOVE AVE, ORANGE, CA 92869-1939
(602) 451-5537
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
10867262-9922
UT
1223P0221X
Pediatric Dentistry
Primary
103401
CA
Other
Enumeration date
07/01/2018
Last updated
11/29/2021
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