Organization · NPI-2

A Nelson Professional Corporation

Dentist, General Practice · Palos Heights, IL

NPI number1245350321
StatusActive
Last updated in NPPESJul 7, 2008

Details

NPI
1245350321
Entity type
Organization (NPI-2)
Legal business name
A Nelson Professional Corporation
Organization subpart
No
Enumeration date
Mar 30, 2007
Last updated
Jul 7, 2008

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1223G0001X Dentist, General Practice019023339ILYes
1223G0001X Dentist, General Practice019024471IL

Other names

  • The Dentist Tree (Doing Business As)

Practice location

6420 W 127th St
Suite 102
Palos Heights, IL 60463

Phone 708-597-3531

Mailing address

6420 W 127th St
Suite 102
Palos Heights, IL 60463

Phone 708-597-3531

Authorized official

Erik L Nelson
Vice President
7085973531

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