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Individual

JOHN HENRY KELSEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.D.S., M.S.

Contact information

Practice address
534 W 19TH ST, COSTA MESA, CA 92627-2748
(714) 571-3392
Mailing address
33 CENTRE CT, DANA POINT, CA 92629-4105
(847) 334-4050

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
021001805
IL
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
62784
CA

Other

Enumeration date
05/23/2008
Last updated
07/21/2022
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