Individual
KELLY HILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
320 W BRISTOL ST, ELKHART, IN 46514-3085
(574) 266-6107
Mailing address
2956 SEASONS DR, GREENWOOD, IN 46143-6798
(574) 339-0089
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
12012379A
IN
Other
Enumeration date
06/07/2018
Last updated
06/07/2018
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