Provider Demographics
NPI:1114239464
Name:LUFF, KELVAN CLIFFORD (DDS)
Entity Type:Individual
Prefix:DR
First Name:KELVAN
Middle Name:CLIFFORD
Last Name:LUFF
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 STEWART CT
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:CO
Mailing Address - Zip Code:80516-6884
Mailing Address - Country:US
Mailing Address - Phone:352-216-2846
Mailing Address - Fax:
Practice Address - Street 1:10 STEWART CT
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:CO
Practice Address - Zip Code:80516-6884
Practice Address - Country:US
Practice Address - Phone:352-216-2846
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-01
Last Update Date:2016-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX283241223X0400X, 1223G0001X
CO2019831223G0001X, 1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
No1223G0001XDental ProvidersDentistGeneral Practice