Individual
RICHARD T NELSON III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
7878 JEFFERSON PAIGE RD, SHREVEPORT, LA 71119-8865
(504) 460-9397
Mailing address
7878 JEFFERSON PAIGE RD, SHREVEPORT, LA 71119-8865
(504) 460-9397
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DN013278
GA
Other
Enumeration date
07/26/2007
Last updated
07/26/2007
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