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Individual

DR. KELLY L CLARKSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DDS

Contact information

Practice address
3715 BLOOMINGTON ST UNIT 160, COLORADO SPRINGS, CO 80922-3207
(719) 599-0665
Mailing address
3066 E COMMERCE ST, SAN ANTONIO, TX 78220-1013
(210) 233-7062
(210) 434-1704

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
202014
CO
1223G0001X
General Practice Dentistry
25029
TX
1223G0001X
General Practice Dentistry
6664
NE

Other

Enumeration date
10/10/2006
Last updated
09/03/2025
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