Severance Dental, PLLC

Organization Active NPI General Practice Dentistry · Severance, CO

NPI 1790288744 · NPPES record last updated Mar 15, 2018

Key facts

NPI
1790288744
Entity type
Organization (NPI type 2)
Primary specialty
General Practice Dentistry 1223G0001X
Legal business name
SEVERANCE DENTAL, PLLC
Practice address
375 W 4TH Ave
Severance, CO 80550-2949
Phone
(970) 693-0080
NPI assigned
Mar 15, 2018
Organization subpart
No

Authorized official

Name
Dr. Joshua Chad Kelly, DMD
Title
Owner
Phone
(502) 295-1099

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Locations

375 W 4th Ave
Severance, CO 80550
Phone (970) 693-0080

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry
Group: 193400000X SINGLE SPECIALTY GROUP
1223G0001X Yes

Addresses

Primary practice location

375 W 4TH Ave
Severance, CO 80550-2949

Mailing address

1581 Windshire Dr
Windsor, CO 80550-5823
Phone (502) 295-1099

Other providers in Severance, CO

All providers in Severance, CO · General Practice Dentistry in Colorado

Sources for this page

Verify at the official NPI Registry.