| R. Kelly Dds, Inc. | |
|
951 N Tustin St Orange CA 92867-5902 | |
| (714) 532-3331 | |
| (714) 532-5886 |
| Full Name | R. Kelly Dds, Inc. |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 951 N Tustin St, Orange, California |
| Authorized Official Name and Position | Russell A. Kelly (OWNER) |
| Authorized Official Contact | 7145323331 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| R. Kelly Dds, Inc. 951 N Tustin St Orange CA 92867-5902 Ph: (714) 532-3331 | R. Kelly Dds, Inc. 951 N Tustin St Orange CA 92867-5902 Ph: (714) 532-3331 |
| NPI Number | 1013116656 |
|---|---|
| Provider Enumeration Date | 07/13/2007 |
| Last Update Date | 07/13/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013116656 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 43284 (California) | Primary |
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