Individual
DR. CHARLES DALE KELLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
603 S 1ST ST, LAMAR, CO 81052-3205
(719) 336-7719
Mailing address
603 SOUTH FIRST STREET, LAMAR, CT 81052
(719) 336-7719
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3591
CO
Other
Enumeration date
02/09/2007
Last updated
07/08/2007
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