Individual
KELLIE HANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
221 S JEFFERS ST STE 1, NORTH PLATTE, NE 69101-5371
(308) 534-4040
Mailing address
38224 S DARNELL RD, WELLFLEET, NE 69170-7064
(308) 362-4356
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7482
NE
Other
Enumeration date
06/20/2018
Last updated
06/20/2018
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