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Individual

DR. KELLY ELIZABETH CANAVAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DDS

Contact information

Practice address
8301 S HOLLAND RD STE B, CHICAGO, IL 60620-1303
(773) 488-2444
Mailing address
37 W 8TH AVE UNIT 1, COLUMBUS, OH 43201-2301
(513) 604-1721

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019.032392
IL
1223G0001X
General Practice Dentistry
30.025723
OH

Other

Enumeration date
05/23/2019
Last updated
10/24/2019
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