NPI 1972760916

Rick Nelson Endodontic PC

Organisation Preferred Provider Organization Windsor Heights, IA

Practice location

Address: 974 73rd St Suite 18, Windsor Heights, IA 50312-1024
Phone: (515) 223-0602
Fax: (515) 223-7346
Mailing address: 974 73rd Street Suite 18, Windsor Heights, IA 50312-1026

Authorised official

Name: Ricky Dean Nelson
Title: President
Phone: (515) 223-0602

Registered specialties

Preferred Provider Organization Primary

Managed Care Organizations Taxonomy 305R00000X Licence 06911 (IA)

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Registry record

NPI: 1972760916
Entity type: Organization
NPI issued: 19 May 2008
Record last updated: 19 May 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.