Individual
MR. MARK ALAN NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
102 JANESVILLE STREET, OREGON, WI 53575-1527
(608) 835-9200
Mailing address
102 JANESVILLE STREET, OREGON, WI 53575-1527
(608) 835-9200
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5000807015
WI
Other
Enumeration date
05/22/2008
Last updated
05/22/2008
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