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Individual

DR. TERRY MICHAEL KELLY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
10150 HIGHLAND MANOR DR, SUITE 145, TAMPA, FL 33610-9713
(813) 682-2401
(813) 682-2402
Mailing address
10150 HIGHLAND MANOR DR, SUITE 145, TAMPA, FL 33610-9713
(813) 682-2401
(813) 682-2402

Taxonomy

Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
DN11407
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
DN11407
LICENSE
FL
Enumeration date
06/29/2007
Last updated
01/11/2016
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