Most Relevant Information
Provider Data
| NPI Number: | 1003806027 |
| Provider Name: | MICHAEL NELSON |
| Entity Type: | Individual |
| Taxonomy Code: | 1223G0001X |
| Specialty: | Dentist |
| License Number: | D12133 |
Most Important Dates
| Enumeration Date: | 10/21/2005 |
| Last Updated: | 07/08/2007 |
Provider Practice Location
13550 26TH AVE N
PLYMOUTH
MN
554413650
Practice Location Phone/Fax
| Phone: | 9529290641 |
| Fax: |
Provider Mailing Location
5100 EDEN AVE
EDINA
MN
554362337
Provider Mailing Phone/Fax
| Phone: | 9529290641 |
| Fax: |