Individual
BROCK T NELSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
5121 S SOLBERG AVE #120, SIOUX FALLS, SD 57108
(605) 339-2955
Mailing address
46219 PELICAN CV, WENTWORTH, SD 57075-7518
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D1158
SD
Other
Enumeration date
06/14/2017
Last updated
06/14/2017
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