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Individual
DR. JOHN PATRICK WASHINGTON KELLY
Active
Individual
DR. JOHN PATRICK WASHINGTON KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., D.M.D.
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
008783
CT
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
038903
CT
Other
Enumeration date
06/10/2006
Last updated
10/12/2007
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