Individual
ANNELISE NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S
Contact information
Practice address
15535 34TH AVE N STE 250, PLYMOUTH, MN 55447-2171
(763) 233-3310
Mailing address
15535 34TH AVE N STE 250, PLYMOUTH, MN 55447-2171
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D13605
MN
Other
Enumeration date
08/12/2015
Last updated
04/23/2018
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