Individual
DR. MICHAEL WILLIAM KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
79 ROUTE 59 STE 4, SUFFERN, NY 10901-4900
(845) 357-0200
Mailing address
79 ROUTE 59 STE 4, SUFFERN, NY 10901-4900
(845) 357-0200
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
051619
NY
Other
Enumeration date
09/27/2022
Last updated
09/27/2022
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