| Kelly Family Dentistry, Pc | |
|
1690 N Main Street Huntingburg IN 47542 | |
| (812) 683-1112 | |
| (888) 958-7816 |
| Full Name | Kelly Family Dentistry, Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1690 N Main Street, Huntingburg, Indiana |
| Authorized Official Name and Position | Christian H Kelly (OWNER/DENTIST) |
| Authorized Official Contact | 8126831112 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kelly Family Dentistry, Pc 1690 N Main Street Huntingburg IN 47542 Ph: (812) 683-1112 | Kelly Family Dentistry, Pc 1690 N Main Street Huntingburg IN 47542 Ph: (812) 683-1112 |
| NPI Number | 1457620783 |
|---|---|
| Provider Enumeration Date | 12/15/2011 |
| Last Update Date | 08/22/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457620783 | NPI | - | NPPES |
| 200902290A | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 12011133A (Indiana) | Primary |
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