Kelly Mansfield, D.D.S

NPI 1982616983 · on the registry since 2006 · sole proprietor

Practice

Address: 109 12th Ave Rd
Nampa, ID 83686
Phone: (208) 467-9271
Fax: (208) 466-3609
Organisation at this address: Russell C. Pool, Dmd, Pa
Kelly B. Mansfield Dds Pc
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 3

Registry record

Primary taxonomy: 1223G0001X
1223G0001X
Licence states on file: ID
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2007-07-08

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Idaho