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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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