Provider Demographics
NPI:1659574994
Name:KEMMET, LORI ANN (DDS)
Entity Type:Individual
Prefix:DR
First Name:LORI
Middle Name:ANN
Last Name:KEMMET
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1735 VIEW POINT RD
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80305-6813
Mailing Address - Country:US
Mailing Address - Phone:303-499-9402
Mailing Address - Fax:303-499-0023
Practice Address - Street 1:4150 DARLEY AVE
Practice Address - Street 2:SUITE 3
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80305-6557
Practice Address - Country:US
Practice Address - Phone:303-499-0013
Practice Address - Fax:303-499-0023
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO69291223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice