Organization
KELLY WEST, DDS COSMETIC & FAMILY DENITSTRY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KELLY LYNN WEST DDS (OWNER/DENTIST)
(817) 234-9378
Entity
Organization
Contact information
Practice address
608 E BAILEY BOSWELL RD, 100, SAGINAW, TX 76131-3569
(817) 234-9378
Mailing address
608 E BAILEY BOSWELL RD, 100, SAGINAW, TX 76131-3569
(817) 234-9378
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
21325
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1669703088
TYPE 1
TX
Enumeration date
02/03/2010
Last updated
02/03/2010
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