# PAUL KELLY MAXILLOFACIAL PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1316324031
- **Authorized official:** DR. PAUL JOHN KELLY DMD MS (DOCTOR AND OWNER)
- **Authorized official phone:** (480) 258-0879

## Contact information

- **Practice address:** 726 N GREENFIELD RD, SUITE \#117, GILBERT, AZ 85234-5061
- **Practice address phone:** (480) 258-0879
- **Mailing address:** 726 N GREENFIELD RD, SUITE \#117, GILBERT, AZ 85234-5061
- **Mailing address phone:** (480) 258-0879

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | D6913 | AZ | Yes |

## Other

- **Enumeration date:** 05/01/2015
- **Last updated:** 05/01/2015