Provider Demographics
NPI:1184180036
Name:BRETT NELSON DDS PLLC
Entity Type:Organization
Organization Name:BRETT NELSON DDS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRETT
Authorized Official - Middle Name:T
Authorized Official - Last Name:NELSON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:303-475-8157
Mailing Address - Street 1:340 E 1ST AVE STE 202
Mailing Address - Street 2:
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80020-2445
Mailing Address - Country:US
Mailing Address - Phone:303-466-4646
Mailing Address - Fax:303-404-8804
Practice Address - Street 1:340 E 1ST AVE STE 202
Practice Address - Street 2:
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80020-2445
Practice Address - Country:US
Practice Address - Phone:303-466-4646
Practice Address - Fax:303-404-8804
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-15
Last Update Date:2019-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental