Organization
MICHAEL J KELLOGG DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL J KELLOGG DDS (PRESIDENT)
(303) 772-3313
Entity
Organization
Contact information
Practice address
1616 MOUNTAIN VIEW AVE, LONGMONT, CO 80501-3210
(303) 772-3313
Mailing address
1616 MOUNTAIN VIEW AVE, LONGMONT, CO 80501-3210
(303) 772-3313
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
230
CO
Other
Enumeration date
08/16/2006
Last updated
08/22/2020
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