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1396810123
KEVIN T. NELSON
PEORIA, IL
NPI
1396810123
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1223G0001X Dentist, General Practice
(Licence: IL 019021153)
Enumeration Date
2006-11-20
Last Update Date
2007-07-08
Business Address
Dr. KEVIN T. NELSON D.D.S.
1116 W LOUCKS AVE
PEORIA, IL 61604-2677
Phone number: 309-688-2112
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Mailing Address
Dr. KEVIN T. NELSON D.D.S.
1116 W LOUCKS AVE
PEORIA, IL 61604-2677
Phone number: 309-688-2112
Copy
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