Individual
JEFFREY ADAM KELLEY SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2924 W 6TH ST, FORT WORTH, TX 76107-2213
(817) 877-1651
(817) 877-3337
Mailing address
2924 W 6TH ST, FT WORTH, TX 76107-2213
(817) 877-1651
(817) 877-3337
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
14320
TX
Other
Enumeration date
09/07/2006
Last updated
07/08/2007
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