MEDICARE: DR. KELSEY DORINE SNAVELY AKIN D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223P0221X	Pediatric Dentistry	9659	CO

General Provider Information

NPI Number	:	1093975666
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KELSEY DORINE SNAVELY AKIN D.D.S.

Provider Business Mailing Address
First Line	:	4383 TENNYSON ST UNIT 1-F
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80212-2315
Country	:	US
Telephone Number	:	303-423-4383
Fax Number	:

Provider Business Practice Location Address
First Line	:	4383 TENNYSON ST UNIT 1-F
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80212-2315
Country	:	US
Telephone Number	:	303-423-4383
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/16/2008
Last Update Date	:	04/14/2017

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