Individual
KELLI GUTTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2953 BROAD AVE, MEMPHIS, TN 38112-2957
(901) 701-6064
Mailing address
1537A 12TH AVE N, NASHVILLE, TN 37208-2024
(601) 327-9116
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
11637
TN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/20/2021
Last updated
08/10/2021
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