Organization
KELLS DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICIA IZQUIERDO (OWNER)
(917) 572-3637
Entity
Organization
Contact information
Practice address
116 39TH ST APT 4, UNION CITY, NJ 07087-6139
(917) 572-3637
Mailing address
2807 JACKSON AVE, LONG ISLAND CITY, NY 11101-3458
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
11/14/2022
Last updated
11/14/2022
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