Individual
JOSHUA CHAD KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
375 W 4TH AVE, SEVERANCE, CO 80550
(970) 693-0080
(970) 693-0081
Mailing address
375 W 4TH AVE, SEVERANCE, CO 80550-2949
(970) 693-0080
(970) 693-0081
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DEN.00202592
CO
Other
Enumeration date
07/29/2015
Last updated
07/03/2018
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