Individual
DR. ROY WILLIAM KELLY JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1725 S NEW HOPE RD, GASTONIA, NC 28054-5850
(704) 867-1671
(704) 867-0533
Mailing address
7026 LAKESIDE POINT DR, BELMONT, NC 28012-8876
(704) 825-7339
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3944
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8994825
—
NC
01
—
94825
BCBS
NC
Enumeration date
08/10/2006
Last updated
08/11/2008
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