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General NPI Number Information
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NPI Number | 1114239464
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Entity Type | Individual
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Provider Name | KELVAN CLIFFORD LUFF D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 07/01/2010
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Last Update Date | 09/29/2016
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Provider Practice Location Address
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Address Line | 10 STEWART CT
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City | ERIE
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State | CO
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Zip | 80516-6884
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Country | US
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Telephone | 352-216-2846
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Fax |
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Provider Business Mailing Address
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Address Line | 10 STEWART CT
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City | ERIE
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State | CO
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Zip | 80516-6884
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Country | US
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Telephone | 352-216-2846
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 28324
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 28324
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 201983
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License Number State | CO
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Taxonomy #4
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 201983
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License Number State | CO
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