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Organization

TIMOTHY L KELLY DDS

Active
Other names
Rushmore Dental
Organization subpart
No

Provider details

NPI number
Authorized official
DR. TIMOTHY LYNN KELLY DDS (PRESIDENT)
(605) 430-9748
Entity
Organization

Contact information

Practice address
1600 MOUNTAIN VIEW RD, SUITE 104, RAPID CITY, SD 57702-4381
(605) 430-9748
Mailing address
1600 MOUNTAIN VIEW RD, SUITE 104, RAPID CITY, SD 57702-4381
(605) 430-9748

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D0505
SD

Other

Enumeration date
01/19/2016
Last updated
03/18/2016
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