Randall James Kelley, D.M.D.

NPI #1538387154 in Provo, Utah

Provider Information

NPI Number: 1538387154
Entity Type: Individual
Name: Randall James Kelley, D.M.D.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist - General Practice
Credential: D.M.D.
Enumeration Date: Apr 20, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 275 N 500 W
Address 2: SUITE C
City: Provo
State: Utah
ZIP Code: 84601-3006
Phone: (801) 374-5768

Specialties & Taxonomy Codes

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

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