# KELLY WEST, DDS COSMETIC & FAMILY DENITSTRY, PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1306178249
- **Authorized official:** DR. KELLY LYNN WEST DDS (OWNER/DENTIST)
- **Authorized official phone:** (817) 234-9378

## Contact information

- **Practice address:** 608 E BAILEY BOSWELL RD, 100, SAGINAW, TX 76131-3569
- **Practice address phone:** (817) 234-9378
- **Mailing address:** 608 E BAILEY BOSWELL RD, 100, SAGINAW, TX 76131-3569
- **Mailing address phone:** (817) 234-9378

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | 21325 | TX | Yes |

## Other

- **Enumeration date:** 02/03/2010
- **Last updated:** 02/03/2010