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Organization
MARIE PETTERS KELLY
Active
Organization
MARIE PETTERS KELLY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL KELLY (GM)
(717) 925-4327
Entity
Organization
Contact information
Practice address
1670 LINCOLN HWY E, LANCASTER, PA 17602-2663
(717) 394-1067
Mailing address
1670 LINCOLN HWY E, LANCASTER, PA 17602-2663
(717) 394-1067
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
DS025788L
PA
261QD0000X
Dental Clinic/Center
DS035577
PA
261QD0000X
Dental Clinic/Center
DS040000
PA
Other
Enumeration date
05/16/2018
Last updated
05/16/2018
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