Individual
DR. KELLEY ELAINE HEAL-ORTIZ
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
432 W MAIN ST, CLARKSBURG, WV 26301-2817
(304) 622-9837
(304) 623-1754
Mailing address
432 W MAIN ST, CLARKSBURG, WV 26301-2817
(304) 622-9837
(304) 623-1754
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
WV3030
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0133029000
—
WV
01
—
781440
UNITED CONCORDIA
WV
Enumeration date
06/07/2006
Last updated
07/09/2007
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