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
Phone: (715) 398-3239
Fax: (715) 398-5799
Website:
Health care specialties
| Specialty | Code | License # | 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 5 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1003982406 | NPPES |
| Wisconsin | MEDICAID | 33679400 | |
| Wisconsin | Other | 437434 | |
| Wisconsin | Other | WI 3898 | |
| Wisconsin | Other | 06508NE |
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