Individual
KELLY O'SHAUGHNESSY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
3245 HOSPITAL DR, JUNEAU, AK 99801-7809
(907) 463-4050
Mailing address
5659 WINTER GARDEN CT, SAINT LOUIS, MO 63129-5905
(314) 780-3175
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2015027487
MO
Other
Enumeration date
01/31/2016
Last updated
01/31/2016
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