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Individual

DR. KELLY MARTINEZ OWEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.D.S.

Contact information

Practice address
3302 GASTON AVE, DALLAS, TX 75246-2013
(210) 602-7985
Mailing address
3302 GASTON AVE, DALLAS, TX 75246-2013
(210) 602-7985

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
27993
TX

Other

Enumeration date
02/14/2013
Last updated
02/14/2013
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