Individual
JOHN KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4833 BETHESDA AVE STE 302, BETHESDA, MD 20814-5244
(301) 657-3220
Mailing address
4833 BETHESDA AVE STE 302, BETHESDA, MD 20814-5244
(301) 657-3220
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
9294
MD
Other
Enumeration date
12/17/2014
Last updated
12/17/2014
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