# KEITH W KELLEY DDS PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** A Center For Family Dentistry
- **Organization subpart:** No

## Provider details

- **NPI number:** 1689763872
- **Authorized official:** DR. KEITH W KELLEY DDS (OWNER PRESIDENT)
- **Authorized official phone:** (248) 828-3185

## Contact information

- **Practice address:** 1913 W SOUTH BLVD, TROY, MI 48098
- **Practice address phone:** (248) 828-3185
- **Practice address fax:** (248) 828-0197
- **Mailing address:** 1913 W SOUTH BLVD, TROY, MI 48098
- **Mailing address phone:** (248) 828-3185
- **Mailing address fax:** (248) 828-0197

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 2901013476 | MI | Yes |

## Other

- **Enumeration date:** 10/12/2006
- **Last updated:** 10/02/2007