Kenneth J. Kelly DDS

NPI 1003883083 - Dentist - 1223G0001X

NPI Details
NPI 1003883083
Gender Male
Enumeration Date 03/08/2006
Last Updated 04/07/2009
Entity Type Individual
Active Over 10 years ago
Practice Location
111 GROSSMAN DR
BRAINTREE MA, 02184-4997, US
Phone (781) 849-2255
Fax
Business Location
147 MILK ST
PROVIDER ENROLLMENT 9TH FLOOR
BOSTON MA, 02109-4806, US
Phone (617) 559-8051
Fax
Toxanomy
Taxonomy Code 1223G0001X
License State Massachusetts
License Number 15939
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According to our database, Kenneth J. Kelly DDS NPI is 1003883083, taxonomy code is 1223G0001X and license number is 15939, license state is located at Massachusetts. Kenneth J. Kelly DDS physically located at 111 Grossman Dr, Braintree MA, 02184-4997. NPI Number Kenneth J. Kelly DDS has the Individual type.

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1003883083 NPI number is provided on an as is basis without warranty of any kind. 1003883083 is maintained by the National Plan & Provider Enumeration System. The contents of Kenneth J. Kelly DDS are for informational purposes only.