Individual
DR. TIMOTHY MARK KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
1441 CARLISLE BLVD NE, SUITE D, ALBUQUERQUE, NM 87110-5610
(505) 256-1770
(505) 255-0220
Mailing address
1441 CARLISLE BLVD NE, SUITE D, ALBUQUERQUE, NM 87110-5610
(505) 256-1770
(505) 255-0220
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1413
NM
Other
Enumeration date
01/26/2007
Last updated
07/03/2020
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