Individual
DR. MICHELLE J KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
11 CROSSROADS CT, DELAFIELD, WI 53018-2035
(262) 646-4188
(262) 646-4181
Mailing address
36032 RAVINIA PARK BLVD, OCONOMOWOC, WI 53066-6714
(414) 975-7190
(262) 646-4181
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5721-015
WI
Other
Enumeration date
12/14/2005
Last updated
07/21/2022
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