Individual
SARAH KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
3701 HULEN ST, FORT WORTH, TX 76107-6803
(817) 738-3510
Mailing address
3701 HULEN ST, FORT WORTH, TX 76107-6803
(817) 738-3510
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
38236
TX
1223P0300X
Periodontics
PENDING
TX
Other
Enumeration date
07/15/2019
Last updated
07/20/2022
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