Individual
JACQUELINE KELLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
3141 BEAUMONT CENTRE CIR, LEXINGTON, KY 40513-1960
(859) 223-2120
Mailing address
1612 HIGBEE MILL ROAD, LEXINGTON, KY 40503
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
11130
KY
Other
Enumeration date
05/31/2024
Last updated
06/13/2024
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