Individual
KELSEY GREENHALGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
760 MONTAUK HWY STE 10, CENTER MORICHES, NY 11934-2230
(631) 878-9300
Mailing address
321 PINE HILLS DR, MANORVILLE, NY 11949-3454
(631) 905-6295
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
063396
NY
390200000X
Student in an Organized Health Care Education/Training Program
12501
CT
Other
Enumeration date
03/21/2019
Last updated
01/23/2025
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