Nelson, Jon Gregorie

Nelson, Jon Gregorie is an sole proprietor health care provider with primary practice located at 418 23Rd Ave E , Superior WI 54880-3707. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Nelson, Jon Gregorie can be contacted via phone (715) 398-3239.

Contact Information

Primary practice address
418 23Rd Ave E Superior WI 54880-3707
Fax: (715) 398-5799
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X WI 3898 Wisconsin

Profile Details

NPI number 1003982406
LBN Legal business name Nelson, Jon Gregorie
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 28th, 2006
Last updated Mar 30th, 2021 - about 3 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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Identifiers

StateTypeNumberIssuer
All States NPI 1003982406 NPPES
Wisconsin MEDICAID 33679400
Wisconsin Other 437434
Wisconsin Other WI 3898
Wisconsin Other 06508NE

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