Individual
KELSEY JO FRASER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
515 N BROADWAY AVE STE 4, RED LODGE, MT 59068
(406) 662-0272
Mailing address
4448 PINE COVE RD, BILLINGS, MT 59106-1335
(406) 853-1676
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DEN-DEN-LIC-13445
MT
1223G0001X
General Practice Dentistry
Primary
13445
MT
Other
Enumeration date
06/10/2017
Last updated
06/26/2019
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