Individual
ROY WILLIAM KELLY III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1725 S NEW HOPE RD, GASTONIA, NC 28054-5850
(704) 867-1671
(704) 867-0533
Mailing address
3529 COUNTRY CLUB DR, GASTONIA, NC 28056-6664
(704) 860-1328
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7779
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
94825
BCBS
—
Enumeration date
09/27/2006
Last updated
08/11/2008
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