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Organization

R PAUL KELSON DDS MS PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
R PAUL KELSON (DDS MS PA)
(208) 378-1300
Entity
Organization

Contact information

Practice address
10497 GARVERDALE CT, SUITE #103, BOISE, ID 83704
(208) 378-1300
(208) 378-1434
Mailing address
10497 GARVERDALE CT, SUITE #103, BOISE, ID 83704
(208) 378-1300
(208) 378-1434

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
D1561OR
ID

Other

Enumeration date
11/01/2006
Last updated
07/09/2008
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