Individual
KELLY GWEN BLISS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
128 MEDWAY RD STE 2&3, MILFORD, MA 01757-2915
(781) 325-1091
Mailing address
121 LINDEN ST, DOUGLAS, MA 01516-2467
(508) 404-6751
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN1859382
MA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/31/2022
Last updated
02/07/2023
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