Provider Demographics
NPI:1427460260
Name:NELSON, NATALIE VIRGINIA (DDS)
Entity type:Individual
Prefix:DR
First Name:NATALIE
Middle Name:VIRGINIA
Last Name: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 1:2100 MARKET ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:WHEELING
Mailing Address - State:WV
Mailing Address - Zip Code:26003-3828
Mailing Address - Country:US
Mailing Address - Phone:304-232-6956
Mailing Address - Fax:304-234-8824
Practice Address - Street 1:2100 MARKET ST
Practice Address - Street 2:SUITE 201
Practice Address - City:WHEELING
Practice Address - State:WV
Practice Address - Zip Code:26003-3828
Practice Address - Country:US
Practice Address - Phone:304-232-6956
Practice Address - Fax:304-234-8824
Is Sole Proprietor?:No
Enumeration Date:2014-05-28
Last Update Date:2014-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV4106122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist