DR. Keith Allen Van Tassell, D.D.S.

NPI #1366585408 in Fort Collins, Colorado

Provider Information

NPI Number
1366585408
Entity Type
Individual
Name
DR. Keith Allen Van Tassell, D.D.S.
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Dentist - Pediatric Dentistry
Credential
D.D.S.
Enumeration Date
Feb 15, 2007
Last Updated
Jul 8, 2007

Practice Location

Address
2001 S SHIELDS ST BLDG A
Address 2
SUITE 2
ZIP Code
80526-1827
Phone
(970) 484-4104

Specialties & Taxonomy Codes

Specialty
Dentist - Pediatric DentistryPediatric Dentistry

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