Individual
MERRILL D NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1015 GREELEY AVE, GLENCOE, MN 55336
(320) 864-3129
(320) 864-4920
Mailing address
1015 GREELEY AVE, GLENCOE, MN 55336
(320) 864-3129
(320) 864-4920
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7739
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7739
LIC #
MN
Enumeration date
11/01/2006
Last updated
07/08/2007
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