# KELLY BLAIR D.D.S., PLLC

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

## Provider details

- **NPI number:** 1699262493
- **Authorized official:** DR. KELLY BLAIR DDS (OWNER/DENTIST)
- **Authorized official phone:** (817) 737-5155

## Contact information

- **Practice address:** 6316 CAMP BOWIE BLVD, FORT WORTH, TX 76116-5418
- **Practice address phone:** (817) 737-5155
- **Practice address fax:** (817) 737-4095
- **Mailing address:** 6316 CAMP BOWIE BLVD, FORT WORTH, TX 76116-5418
- **Mailing address phone:** (817) 737-5155
- **Mailing address fax:** (817) 737-4095

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | Yes |

## Other

- **Enumeration date:** 04/17/2018
- **Last updated:** 05/08/2018