Individual
DR. KELLY S LAST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
3092 EVERGREEN PKWY, #100, EVERGREEN, CO 80439-7849
(303) 674-6264
Mailing address
3092 EVERGREEN PKWY, #100, EVERGREEN, CO 80439-7849
(303) 674-6264
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
9378
CO
Other
Enumeration date
06/19/2009
Last updated
11/18/2009
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