Organization
SEVERANCE DENTAL, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSHUA CHAD KELLY DMD (OWNER)
(502) 295-1099
Entity
Organization
Contact information
Practice address
375 W 4TH AVE, SEVERANCE, CO 80550-2949
(970) 693-0080
Mailing address
1581 WINDSHIRE DR, WINDSOR, CO 80550-5823
(502) 295-1099
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
03/15/2018
Last updated
03/15/2018
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