Individual
DR. KEITH ALLAN COLWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
6057 SE 14TH ST, DES MOINES, IA 50320-1704
(515) 285-4759
(515) 287-2948
Mailing address
9513 NW NEWGATE DR, JOHNSTON, IA 50131-2959
(515) 986-3489
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5559
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6005942
—
IA
05
—
7005942
—
IA
Enumeration date
11/10/2006
Last updated
07/08/2007
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