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Individual

DR. SCOTT S KELLY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
116 W JOHN ST, MAUMEE, OH 43537-2145
(419) 893-6971
(419) 893-1137
Mailing address
116 W JOHN ST, MAUMEE, OH 43537-2145
(419) 893-6971
(419) 893-1137

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
16259
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0215467
OH
Enumeration date
11/02/2006
Last updated
07/08/2007
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