Individual
MACKENZIE KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1809 JANCEY ST, PITTSBURGH, PA 15206-1065
(412) 362-5677
(412) 362-0742
Mailing address
1809 JANCEY ST, PITTSBURGH, PA 15206-1065
(412) 362-5677
(412) 362-0742
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS041272
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
99455663
DENTPIN
IN
Enumeration date
03/23/2016
Last updated
07/21/2022
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