Matthew J. Kelly, Dds, Llc | |
9 E Van Buren St Millstadt IL 62260-2009 | |
(314) 249-1514 | |
Not Available |
Full Name | Matthew J. Kelly, Dds, Llc |
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Speciality | Dentist - General Practice |
Location | 9 E Van Buren St, Millstadt, Illinois |
Authorized Official Name and Position | Matthew Kelly (MANAGER) |
Authorized Official Contact | 3142491514 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Matthew J. Kelly, Dds, Llc 9 E Van Buren St Millstadt IL 62260-2009 Ph: () - | Matthew J. Kelly, Dds, Llc 9 E Van Buren St Millstadt IL 62260-2009 Ph: (314) 249-1514 |
NPI Number | 1144625773 |
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Provider Enumeration Date | 10/24/2014 |
Last Update Date | 10/24/2014 |
Identifier | Type | State | Issuer |
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1144625773 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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1223G0001X | Dentist - General Practice | 019030041 (Illinois) | Primary |