# JOSEPH T. KELLY DMD PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Kelly Dental Care
- **Organization subpart:** No

## Provider details

- **NPI number:** 1679682751
- **Authorized official:** DR. JOSEPH THOMAS KELLY JR. DMD (PRESIDENT/OWNER)
- **Authorized official phone:** (570) 587-4787

## Contact information

- **Practice address:** 103 WEST GROVE ST, CLARKS SUMMIT, PA 18411-2019
- **Practice address phone:** (570) 587-4787
- **Practice address fax:** (570) 586-2375
- **Mailing address:** 103 WEST GROVE ST, CLARKS SUMMIT, PA 18411-2019
- **Mailing address phone:** (570) 587-4787
- **Mailing address fax:** (570) 586-2375

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | DS017660L | PA | — |
| 122300000X | Dentist | DS028710L | PA | Yes |

## Other

- **Enumeration date:** 08/30/2006
- **Last updated:** 07/24/2013