| NPI | 1467194431 |
|---|---|
| Doing Business As | DIETRICH KELSO ORTHODONTICS |
| Entity Type | Organization |
| Authorized Contact | HEATHER E GRIGSBY Insurance Coordinator 863-644-0430 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2022-04-11 |
| Last Update Date | 2022-04-11 |