Organization
R. KELLY DDS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RUSSELL A. KELLY DDS (OWNER)
(714) 532-3331
Entity
Organization
Contact information
Practice address
951 N TUSTIN ST, ORANGE, CA 92867-5902
(714) 532-3331
(714) 532-5886
Mailing address
951 N TUSTIN ST, ORANGE, CA 92867-5902
(714) 532-3331
(714) 532-5886
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
43284
CA
Other
Enumeration date
07/13/2007
Last updated
07/13/2007
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