Individual
DR. PATRICK THOMAS KELLY
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
3295 FORNEY ST, FORT JACKSON, SC 29207-5604
(803) 751-6213
(803) 751-6886
Mailing address
3295 FORNEY ST, FORT JACKSON, SC 29207-5604
(803) 751-6213
(803) 751-6886
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4069
SC
Other
Enumeration date
12/02/2005
Last updated
07/08/2007
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