Individual
DR. MATTHEW J KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
121 E HIGH ST, LONDON, OH 43140
(740) 852-4470
(740) 852-4429
Mailing address
121 E HIGH ST, LONDON, OH 43140
(740) 852-4470
(740) 852-4429
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
17742
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0582561
—
OH
Enumeration date
07/24/2007
Last updated
07/24/2007
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