Nelson, Gary Randall

Nelson, Gary Randall is an individual health care provider with primary practice located at 2730 Sw Moody Ave , Portland OR 97201-5042. He recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as his primary health care specialty. Nelson, Gary Randall can be contacted via phone (503) 346-4708.

Contact Information

Primary practice address
2730 Sw Moody Ave Portland OR 97201-5042
Phone: (503) 346-4708
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Pediatric Dentistry 1223P0221X 27908 California
Dental Providers / Pediatric Dentistry 1223P0221X D9864 Oregon

Profile Details

NPI number 1598746687
LBN Legal business name Nelson, Gary Randall
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 7th, 2005
Last updated Jul 22nd, 2014 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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