Individual
KYLE NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS, MS
Contact information
Practice address
1570 ADAMS ST, MANKATO, MN 56001-5192
(507) 386-0288
Mailing address
1570 ADAMS ST, MANKATO, MN 56001-5192
(507) 386-0288
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
D13104
MN
Other
Enumeration date
04/27/2012
Last updated
09/30/2021
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