Provider Demographics
NPI:1316039407
Name:ROCKOW-NELSON, AMIE JEANETTE (DDS)
Entity Type:Individual
Prefix:DR
First Name:AMIE
Middle Name:JEANETTE
Last Name:ROCKOW-NELSON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 S DUFF AVE
Mailing Address - Street 2:SUITE D
Mailing Address - City:AMES
Mailing Address - State:IA
Mailing Address - Zip Code:50010-6600
Mailing Address - Country:US
Mailing Address - Phone:515-956-3700
Mailing Address - Fax:515-956-4232
Practice Address - Street 1:415 S DUFF AVE
Practice Address - Street 2:SUITE D
Practice Address - City:AMES
Practice Address - State:IA
Practice Address - Zip Code:50010-6600
Practice Address - Country:US
Practice Address - Phone:515-956-3700
Practice Address - Fax:515-956-4232
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA080591223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice