Organization
R. PAUL KELSON DDS MS ORTHODONTICS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DIANE C. KELSON (SECRETARY)
(208) 375-3397
Entity
Organization
Contact information
Practice address
10497 GARVERDALE COURT, #103, BOISE, ID 83704
(208) 378-1300
(208) 375-3397
Mailing address
10497 GARVERDALE COURT, #103, BOISE, ID 83704
(208) 378-1300
(208) 375-2795
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
01561
ID
Other
Enumeration date
12/17/2008
Last updated
12/17/2008
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