DR. Jerry C. Kelly, DDS

NPI #1386853745 in Marshall, Missouri

Provider Information

NPI Number: 1386853745
Entity Type: Individual
Name: DR. Jerry C. Kelly, DDS
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Dentist
Credential: DDS
Enumeration Date: May 22, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 263 S JEFFERSON AVE
City: Marshall
State: Missouri
ZIP Code: 65340-2134
Phone: (660) 886-6843

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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Organizations

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