Individual
DR. KELLY ELIZABETH GUEDRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
11990 JACKSON ST, CLINTON, LA 70722-3210
(225) 683-5292
(225) 683-1310
Mailing address
3526 BON SEJOUR AVE, BATON ROUGE, LA 70820-5061
(985) 513-0681
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
6349
LA
1223G0001X
General Practice Dentistry
Primary
6349
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1863491
—
LA
Enumeration date
06/05/2013
Last updated
03/19/2024
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