Provider Demographics
NPI:1952460594
Name:THOMAS P NESLUND DMD PC
Entity Type:Organization
Organization Name:THOMAS P NESLUND DMD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:P
Authorized Official - Last Name:NESLUND
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:717-258-5455
Mailing Address - Street 1:13 BROOKWOOD AVENUE
Mailing Address - Street 2:SUITE 3
Mailing Address - City:CARLISLE
Mailing Address - State:PA
Mailing Address - Zip Code:17015
Mailing Address - Country:US
Mailing Address - Phone:717-258-5455
Mailing Address - Fax:717-258-5456
Practice Address - Street 1:13 BROOKWOOD AVENUE
Practice Address - Street 2:SUITE 3
Practice Address - City:CARLISLE
Practice Address - State:PA
Practice Address - Zip Code:17015
Practice Address - Country:US
Practice Address - Phone:717-258-5455
Practice Address - Fax:717-258-5456
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS027395L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty