Individual
DR. JOHN PATRICK WASHINGTON KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., D.M.D.
Contact information
Practice address
1450 CHAPEL ST, MOB-2, NEW HAVEN, CT 06511-4405
(203) 789-3156
(203) 789-3954
Mailing address
1450 CHAPEL ST, MOB-2, NEW HAVEN, CT 06511-4405
(203) 789-3156
(203) 789-3954
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
008783
CT
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
038903
CT
Other
Enumeration date
06/10/2006
Last updated
10/12/2007
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