Individual
DR. KELSEY DIANE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
1317 N MAIN ST, BEAVER DAM, KY 42320-8957
(270) 274-5121
(270) 274-5122
Mailing address
PO BOX 535, BEAVER DAM, KY 42320-0535
(270) 274-5121
(270) 274-5122
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
9595
KY
1223G0001X
General Practice Dentistry
9595
KY
Other
Enumeration date
07/17/2015
Last updated
05/17/2019
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