Individual
CAROL KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DENTAL HYGIENIST
Contact information
Practice address
8550 W 38TH AVE, SUITE 306, WHEAT RIDGE, CO 80033-4300
(303) 467-8888
(303) 467-8801
Mailing address
8550 W 38TH AVE, SUITE 306, WHEAT RIDGE, CO 80033-4300
(303) 467-8888
(303) 467-8801
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
904143
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
12826740
—
CO
Enumeration date
01/31/2013
Last updated
01/31/2013
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