Individual
DR. KELLY LEE KINGMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
3024 VICTORIA ST, BETTENDORF, IA 52722-2793
(563) 332-2447
Mailing address
2217 HARVEST CIR, CORALVILLE, IA 52241-3466
(319) 530-3626
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
08557
IA
Other
Enumeration date
08/14/2008
Last updated
04/23/2012
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