Organization
CROMPTON PARK ORAL SURGERY AND IMPLANT ASSOCIATES, LLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
W DAVID KELLY DMD (MEMBER)
(508) 799-2550
Entity
Organization
Contact information
Practice address
59 QUINSIGAMOND AVE, WORCESTER, MA 01610-1806
(508) 799-2550
Mailing address
59 QUINSIGAMOND AVE, WORCESTER, MA 01610-1806
(508) 799-2550
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
12222
MA
Other
Enumeration date
12/10/2007
Last updated
12/10/2007
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