Individual
MRS. TOMMIE JANAE KELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
EPDH
Contact information
Practice address
235 W MAIN ST FL 2, JACKSONVILLE, OR 97530-9278
(541) 817-6453
Mailing address
PO BOX 816, JACKSONVILLE, OR 97530-0816
(541) 817-6453
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
H6066
OR
Other
Enumeration date
09/25/2018
Last updated
09/25/2018
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