Organization
KELLY ORTHODONTICS, PC
Active
Organization
KELLY ORTHODONTICS, PC
Active
Parent organization
KELLY ORTHODONTICS
Organization subpart
Yes
Provider details
NPI number
Legal business name
KELLY ORTHODONTICS
Authorized official
DR. MICHAEL W KELLY DMD (ORTHODONTIST)
(845) 357-0200
Entity
Organization
Contact information
Practice address
79 ROUTE 59, SUFFERN, NY 10901
(845) 357-0200
(845) 357-0253
Mailing address
79 ROUTE 59, SUFFERN, NY 10901
(845) 357-0200
(845) 357-0253
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
0516191
NY
Other
Enumeration date
04/29/2008
Last updated
02/23/2016
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