Organization
RICK NELSON ENDODONTIC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICKY DEAN NELSON DDS,MS (PRESIDENT)
(515) 223-0602
Entity
Organization
Contact information
Practice address
974 73RD ST, SUITE 18, WINDSOR HEIGHTS, IA 50312-1024
(515) 223-0602
(515) 223-7346
Mailing address
974 73RD STREET, SUITE 18, WINDSOR HEIGHTS, IA 50312-1026
(515) 223-0602
(515) 223-7346
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
06911
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1922095983
TYPE 1 NPI#
IA
Enumeration date
05/19/2008
Last updated
05/19/2008
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