Provider Demographics
NPI:1982830501
Name:NELSON, ALISON MCGEE (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALISON
Middle Name:MCGEE
Last Name:NELSON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:ALISON
Other - Middle Name:KATHERINE
Other - Last Name:MCGEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:1900 W SUNSHINE ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65807-2240
Mailing Address - Country:US
Mailing Address - Phone:417-862-7041
Mailing Address - Fax:
Practice Address - Street 1:1900 W SUNSHINE ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65807-2240
Practice Address - Country:US
Practice Address - Phone:417-862-7041
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-10
Last Update Date:2013-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30-022990122300000X, 1223G0001X
MI2901020175122300000X
MO20112004102122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2901020175OtherMI LICENCE
MO2012004102OtherMO LICENSE
OHODLOther30-022990