Individual
BRIAN KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
9134 MIDDLEBELT RD, LIVONIA, MI 48150-4035
(734) 261-1920
Mailing address
9134 MIDDLEBELT RD, LIVONIA, MI 48150-4035
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2901022677
MI
Other
Enumeration date
06/07/2018
Last updated
06/07/2018
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