Matthew Dixon Kelly

NPI #1699061523 in Page, Arizona

Provider Information

NPI Number: 1699061523
Entity Type: Individual
Name: Matthew Dixon Kelly
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Dentist
Enumeration Date: Jun 20, 2011
Last Updated: Jun 20, 2011

Practice Location

Address: 112 SIXTH AVENUE
City: Page
State: Arizona
ZIP Code: 86040-1956
Phone: (928) 645-3206

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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