Individual
MARTIN KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2695 FLOWOOD DR STE A, FLOWOOD, MS 39232-9358
(601) 939-4100
Mailing address
304 AUTUMN COVE, MADISON, MS 39110
(601) 946-0186
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4274-22
MS
Other
Enumeration date
06/09/2022
Last updated
06/09/2022
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