Organization
WILLIAM M. KELLY, D.D.S., M.S., LTD
Active
Organization
WILLIAM M. KELLY, D.D.S., M.S., LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM M. KELLY D.D.S., M.S. (ORTHODONTIST/OWNER)
(630) 584-9666
Entity
Organization
Contact information
Practice address
11 S 6TH ST, ST CHARLES, IL 60174-2706
(630) 584-9666
(630) 584-9681
Mailing address
11 S 6TH ST, ST CHARLES, IL 60174-2706
(630) 584-9666
(630) 584-9681
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
019013853
IL
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
019026074
IL
Other
Enumeration date
05/29/2009
Last updated
05/29/2009
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