Organization
KERRY KELLY D.D.S., P.C.
Active
Other names
Integrative Oral Health
Organization subpart
No
Provider details
NPI number
Authorized official
KERRY LYN KELLY D.D.S., P.C (OWNER/DENTIST)
(607) 272-4331
Entity
Organization
Contact information
Practice address
1025 N. TIOGA ST., ITHACA, NY 14850
(607) 272-4331
(607) 240-5618
Mailing address
1025 N. TIOGA ST., ITHACA, NY 14850
(607) 272-4331
(607) 240-5618
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02050572
—
NY
Enumeration date
11/19/2018
Last updated
11/19/2018
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