Individual
DR. KELLY NICOLE WEST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1245 CHEYENNE AVE, SUITE 104, GRAFTON, WI 53024
(262) 377-2668
(262) 377-2680
Mailing address
1245 CHEYENNE AVE, SUITE 104, GRAFTON, WI 53024
(262) 377-2668
(262) 377-2680
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
2901018424
MI
1223E0200X
Endodontics
Primary
612915
WI
Other
Enumeration date
09/23/2006
Last updated
09/23/2015
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