Kerry Kelly D.d.s., P.c. | |
1025 N. Tioga St. Ithaca NY 14850 | |
(607) 272-4331 | |
(607) 240-5618 |
Full Name | Kerry Kelly D.d.s., P.c. |
---|---|
Speciality | Dentist |
Location | 1025 N. Tioga St., Ithaca, New York |
Authorized Official Name and Position | Kerry Lyn Kelly (OWNER/DENTIST) |
Authorized Official Contact | 6072724331 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Kerry Kelly D.d.s., P.c. 1025 N. Tioga St. Ithaca NY 14850 Ph: (607) 272-4331 | Kerry Kelly D.d.s., P.c. 1025 N. Tioga St. Ithaca NY 14850 Ph: (607) 272-4331 |
NPI Number | 1700355849 |
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Provider Enumeration Date | 11/19/2018 |
Last Update Date | 11/19/2018 |
Identifier | Type | State | Issuer |
---|---|---|---|
1700355849 | NPI | - | NPPES |
02050572 | Medicaid | NY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | (* (Not Available)) | Primary |
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