Organization
COLORADO WEST ORAL & MAXILLOFACIAL SURGERY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHEN S. KELLY DMD (PRESIDENT)
(970) 245-2222
Entity
Organization
Contact information
Practice address
2530 N 8TH ST STE 103, GRAND JUNCTION, CO 81501-8856
(970) 245-2222
(970) 243-4438
Mailing address
2530 N 8TH ST STE 103, GRAND JUNCTION, CO 81501-8856
(970) 245-2222
(970) 243-4438
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
104240
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04014940
—
CO
Enumeration date
06/13/2008
Last updated
01/14/2021
Update your record
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