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Organization
DENTAL CORPORATION OF KELLY A. ELWARD, DDS
Active
Organization
DENTAL CORPORATION OF KELLY A. ELWARD, DDS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KELLY ANN ELWARD D.D.S. (PRESIDENT)
(707) 539-4646
Entity
Organization
Contact information
Practice address
1820 SONOMA AVE STE 100, SANTA ROSA, CA 95405-6617
(707) 539-4646
(707) 539-3617
Mailing address
1820 SONOMA AVE STE 100, SANTA ROSA, CA 95405-6617
(707) 539-4646
(707) 539-3617
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
42914
CA
Other
Enumeration date
12/28/2012
Last updated
12/28/2012
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