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1033320833
ETHAN BLAKE NELSON
EDENTON, NC
NPI
1033320833
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1223G0001X Dentist, General Practice
(Licence: NC 8393)
Enumeration Date
2007-05-24
Last Update Date
2007-07-08
Business Address
Dr. ETHAN BLAKE NELSON DDS
103 MARK DR
EDENTON, NC 27932-1704
Phone number: 252-482-5131
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Mailing Address
Dr. ETHAN BLAKE NELSON DDS
PO BOX 646
EDENTON, NC 27932-0646
Phone number: 252-482-5131
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