Individual
KELLI ELISE BROOKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
389 AMERICAN WAY, WEIRTON, WV 26062
(304) 748-4210
Mailing address
389 AMERICAN WAY, WEIRTON, WV 26062
(304) 748-4210
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4272
WV
Other
Enumeration date
07/11/2017
Last updated
07/11/2017
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