# KELLY C. ALEXANDER, DDS, LLC

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

## Provider details

- **NPI number:** 1760124366
- **Authorized official:** KELLY C. ALEXANDER DDS (SOLE MEMBER)
- **Authorized official phone:** (330) 245-6107

## Contact information

- **Practice address:** 193 EAST AVE STE 202, TALLMADGE, OH 44278-2341
- **Practice address phone:** (330) 633-0324
- **Mailing address:** 6167 BURR OAK WAY, HUDSON, OH 44236-4914
- **Mailing address phone:** (330) 245-6107

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 04/13/2022
- **Last updated:** 04/13/2022