| Severance Dental, Pllc | |
|
375 W 4th Ave Severance CO 80550-2949 | |
| (970) 693-0080 | |
| Not Available |
| Full Name | Severance Dental, Pllc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 375 W 4th Ave, Severance, Colorado |
| Authorized Official Name and Position | Joshua Chad Kelly (OWNER) |
| Authorized Official Contact | 5022951099 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Severance Dental, Pllc 1581 Windshire Dr Windsor CO 80550-5823 Ph: (502) 295-1099 | Severance Dental, Pllc 375 W 4th Ave Severance CO 80550-2949 Ph: (970) 693-0080 |
| NPI Number | 1790288744 |
|---|---|
| Provider Enumeration Date | 03/15/2018 |
| Last Update Date | 03/15/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790288744 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |