Matthew J. Kelly, Dds, LLC

NPI #1144625773 in Millstadt, Illinois

Provider Information

NPI Number: 1144625773
Entity Type: Organization
Organization Name: Matthew J. Kelly, Dds, LLC
Primary Specialty: Dentist - General Practice
Enumeration Date: Oct 24, 2014
Last Updated: Oct 24, 2014

Practice Location

Address: 9 E VAN BUREN ST
City: Millstadt
State: Illinois
ZIP Code: 62260-2009
Phone: (314) 249-1514

Authorized Official

Name: MATTHEW KELLY
Title: MANAGER
Phone: (314) 249-1514

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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