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General NPI Number Information
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NPI Number | 1154146959
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Entity Type | Organization
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Legal Business Name | CHRIS KELSON DMD MSD PC
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Dates
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Enumeration Date | 11/18/2024
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Last Update Date | 11/18/2024
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Provider Practice Location Address
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Address Line | 5004 N LINDER RD
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City | MERIDIAN
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State | ID
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Zip | 83646-6492
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Country | US
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Telephone | 208-378-1300
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Fax |
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Provider Business Mailing Address
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Address Line | 5004 N LINDER RD
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City | MERIDIAN
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State | ID
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Zip | 83646-6492
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | RCM INTERAGRATIONS MANAGER
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Name | SINDEY LONES
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Credential |
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Telephone | 612-355-7792
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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 |
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License Number State |
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