Individual
DR. KELLY WILKES FORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
321 N LAUREL ST, SUMMERVILLE, SC 29483
(843) 871-6636
(843) 747-9021
Mailing address
321 N LAUREL ST, SUMMERVILLE, SC 29483
(843) 871-6636
(843) 747-9021
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
3045
SC
Other
Enumeration date
01/17/2007
Last updated
07/08/2007
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