# DR. TERRY MICHAEL KELLY

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1750588059
- **Gender:** Man
- **Credential:** DMD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223P0700X | Prosthodontics | DN11407 | FL | Yes |

## Other

- **Enumeration date:** 06/29/2007
- **Last updated:** 01/11/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | DN11407 | LICENSE | FL |