Organization
KELLY BLAIR D.D.S., PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KELLY BLAIR DDS (OWNER/DENTIST)
(817) 737-5155
Entity
Organization
Contact information
Practice address
6316 CAMP BOWIE BLVD, FORT WORTH, TX 76116-5418
(817) 737-5155
(817) 737-4095
Mailing address
6316 CAMP BOWIE BLVD, FORT WORTH, TX 76116-5418
(817) 737-5155
(817) 737-4095
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
04/17/2018
Last updated
05/08/2018
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