Organization
ASPEN TO PARACHUTE DENTAL HEALTH ALLIANCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY JEAN KEEFFE RDH (REGIONAL ORAL HEALTH CONSULTATN)
(970) 309-2064
Entity
Organization
Contact information
Practice address
20 EAGLE COUNTY RD, CARBONDALE, CO 81623-9125
(970) 309-2064
Mailing address
PO BOX 1251, GLENWOOD SPRINGS, CO 81602-1251
(970) 309-2064
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
DH3120
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
90721756
—
CO
Enumeration date
07/17/2014
Last updated
07/17/2014
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