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:
Health care specialties
| Specialty | Code | License # | 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 11 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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