Individual
DR. PAUL JOHN KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS, MS
Contact information
Practice address
726 N GREENFIELD RD, SUITE 117, GILBERT, AZ 85234-5061
(480) 685-9696
(480) 378-3565
Mailing address
726 N GREENFIELD RD, SUITE #117, GILBERT, AZ 85234-5061
(480) 685-9696
(480) 378-3565
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
D6913
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D6913
DENTAL LICENSE
AZ
Enumeration date
05/17/2006
Last updated
06/01/2015
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