Individual
DR. KELLI LONG BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
71 LIMESTONE PKWY, SUITE C, CALERA, AL 35040-7501
(205) 541-3196
Mailing address
71 LIMESTONE PKWY, SUITE C, CALERA, AL 35040-7501
(205) 541-3196
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
8683
NC
1223G0001X
General Practice Dentistry
Primary
5554
AL
Other
Enumeration date
01/13/2009
Last updated
10/19/2010
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