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Individual

MRS. LAURIE LEE KELLY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RDH

Contact information

Practice address
4550 DOGWOOD DR, LAKE OSWEGO, OR 97035-8410
(503) 310-9485
(503) 620-1635
Mailing address
4550 DOGWOOD DR, LAKE OSWEGO, OR 97035-8410
(503) 310-9485
(503) 620-1635

Taxonomy

Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
H2626
OR

Other

Enumeration date
12/27/2006
Last updated
07/08/2007
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