Provider Demographics
NPI:1225170319
Name:NELAMS, HARRY DAVID (DDS)
Entity Type:Individual
Prefix:DR
First Name:HARRY
Middle Name:DAVID
Last Name:NELAMS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:148 COUNTRY LANE DR
Mailing Address - Street 2:
Mailing Address - City:LUMBERTON
Mailing Address - State:TX
Mailing Address - Zip Code:77657-6802
Mailing Address - Country:US
Mailing Address - Phone:409-755-3933
Mailing Address - Fax:409-755-4243
Practice Address - Street 1:148 COUNTRY LN DR
Practice Address - Street 2:
Practice Address - City:LUMBERTON
Practice Address - State:TX
Practice Address - Zip Code:77657
Practice Address - Country:US
Practice Address - Phone:409-755-3933
Practice Address - Fax:409-755-4243
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX172551223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice