| Brent E. Nelsen Dmd, Llc | |
|
1120 N Rock Rd Derby KS 67037-3584 | |
| (316) 789-9999 | |
| (316) 789-9296 |
| Full Name | Brent E. Nelsen Dmd, Llc |
|---|---|
| Speciality | Dentist |
| Location | 1120 N Rock Rd, Derby, Kansas |
| Authorized Official Name and Position | Brent Edward Nelsen (OWNER) |
| Authorized Official Contact | 3167899999 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Brent E. Nelsen Dmd, Llc 1120 N Rock Rd Derby KS 67037-3584 Ph: (316) 789-9999 | Brent E. Nelsen Dmd, Llc 1120 N Rock Rd Derby KS 67037-3584 Ph: (316) 789-9999 |
| NPI Number | 1396149183 |
|---|---|
| Provider Enumeration Date | 10/22/2014 |
| Last Update Date | 10/22/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396149183 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 7193 (Kansas) | Primary |
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