Individual
DR. KELLI L ETTELBRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S., M.S.
Contact information
Practice address
8380 WARREN PKWY, SUITE 400, FRISCO, TX 75034-4198
(214) 387-0099
(214) 387-0104
Mailing address
8380 WARREN PKWY, SUITE 400, FRISCO, TX 75034-4198
(214) 387-0099
(214) 387-0104
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
19146
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
090844401
—
TX
Enumeration date
06/11/2006
Last updated
07/27/2009
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