Individual
GLENN E. KELTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1914 S POWER RD, SUITE 103, MESA, AZ 85206-4376
(480) 641-4633
(480) 641-9432
Mailing address
1914 S POWER RD, SUITE 103, MESA, AZ 85206-4376
(480) 641-4633
(480) 641-9432
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D1640
AZ
Other
Enumeration date
07/06/2006
Last updated
09/18/2007
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