Individual
MR. PATRICK JAMES KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
4009 FORT ST, LINCOLN PARK, MI 48146-4110
(313) 928-8555
(313) 928-1399
Mailing address
4009 FORT ST, LINCOLN PARK, MI 48146-4110
(313) 928-8555
(313) 928-1399
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901016290
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3334958
—
MI
Enumeration date
11/13/2006
Last updated
03/22/2017
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