J. Kelly Theisen, D.d.s.
NPI #1871979393 in Fort Morgan, Colorado
Provider Information
- NPI Number
- 1871979393
- Entity Type
- Organization
- Organization Name
- J. Kelly Theisen, D.d.s.
- Primary Specialty
- Dentist
- Enumeration Date
- Aug 6, 2015
- Last Updated
- Aug 6, 2015
Practice Location
- Address
- 521 E RAILROAD AVENUE
- City
- Fort Morgan
- State
- Colorado
- ZIP Code
- 80701-3331
- Phone
- (970) 867-2256
Authorized Official
- Name
- MR. JOHN KELLY THEISEN, D.D.S.
- Title
- OWNER
- Phone
- (970) 867-2256
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist |
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