Individual
DR. KENNETH RAYMOND KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
402 PRINCETON RD, SUITE A, JOHNSON CITY, TN 37601-2057
(423) 283-4175
Mailing address
402 PRINCETON RD, SUITE A, JOHNSON CITY, TN 37601-2057
(423) 283-4175
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS2230
TN
Other
Enumeration date
02/27/2008
Last updated
02/27/2008
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