Organization
KELLY FAMILY DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRAD JAMES KELLY D.D.S. (OWNER/DENTIST)
(308) 389-2811
Entity
Organization
Contact information
Practice address
2412 W FAIDLEY AVE, GRAND ISLAND, NE 68803-4327
(308) 389-2811
(308) 389-2871
Mailing address
2412 W FAIDLEY AVE, GRAND ISLAND, NE 68803-4327
(308) 389-2811
(308) 389-2871
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
10/08/2012
Last updated
10/08/2012
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