| Kelly And Kelly | |
|
1601c East Garrison Blvd Gastonia NC 28054 | |
| (704) 867-1671 | |
| Not Available |
| Full Name | Kelly And Kelly |
|---|---|
| Speciality | Dentist |
| Location | 1601c East Garrison Blvd, Gastonia, North Carolina |
| Authorized Official Name and Position | R William Kelly (PRESIDENT OWNER) |
| Authorized Official Contact | 7048671671 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kelly And Kelly 1601c East Garrison Blvd Gastonia NC 28054 Ph: (704) 867-1671 | Kelly And Kelly 1601c East Garrison Blvd Gastonia NC 28054 Ph: (704) 867-1671 |
| NPI Number | 1942391370 |
|---|---|
| Provider Enumeration Date | 09/28/2006 |
| Last Update Date | 08/11/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942391370 | NPI | - | NPPES |
| 8994825 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 3944 (North Carolina) | Primary |
| 1223G0001X | Dentist - General Practice | 3944 (North Carolina) | Secondary |
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