J. Kelly Theisen, D.D.S.
Organization Active NPI Dentist · Fort Morgan, CO
NPI 1871979393 · NPPES record last updated Aug 6, 2015
Key facts
- NPI
- 1871979393
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Dentist 122300000X
- License
- DEN00106339 (CO)
- Legal business name
- J. KELLY THEISEN, D.D.S.
- Practice address
- 521 E Railroad Avenue
Fort Morgan, CO 80701-3331 - Phone
- (970) 867-2256
- Fax
- (970) 542-9464
- NPI assigned
- Aug 6, 2015
- Organization subpart
- No
Authorized official
- Name
- Mr. John Kelly Theisen, D.D.S.
- Title
- Owner
- Phone
- (970) 867-2256
Practitioners 1
-
John Kelly Theisen, D.D.S.
National Provider Directory
Locations
521 E Railroad Ave
Fort Morgan, CO 80701
Phone (970) 867-2256
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist |
122300000X | DEN00106339 | CO | Yes |
Addresses
Primary practice location
521 E Railroad Avenue
Fort Morgan, CO 80701-3331
Mailing address
521 E Railroad Avenue
Fort Morgan, CO 80701-3331
Phone (970) 867-2256
Other providers in Fort Morgan, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 6, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.