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DR. DONALD BRYCE NELSON JR. DENTIST

General Practice >> Dentist >> Dental Providers

Registrant NPI Number: 1508937210

Individual Registrant:
DR. DONALD BRYCE NELSON JR. DENTIST
Gender: M
Not Sole Proprietor

Location and contact information for practice:
105 S LAUREL ST  SPRINGFIELD, GA 31329-9255 US
Tel: 912-754-6822  Fax: 912-754-4368

Contact information for business:
105 S LAUREL ST  SPRINGFIELD, GA 31329-9255 US
Tel: 912-754-6822  Fax: 912-754-4368

Registration Information:
NPI: 1508937210
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y1223G0001XDental Providers
Dentist
General Practice
IDDNO12543

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
DORAL9184109GA01
UNITED CONCORDIA1687448GA01




HEALTH CARE JOBS GA - Page 1



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