Individual
JOHN ROY KELLEY JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
3733 SOUTHSIDE BLVD, SUITES 5 & 6, JACKSONVILLE, FL 32216-4684
(904) 996-0111
(904) 996-0140
Mailing address
9000 GOLFSIDE DRIVE, SUITE B, JACKSONVILLE, FL 32256-7793
(904) 367-1722
(904) 367-1739
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN2927
FL
Other
Enumeration date
01/26/2007
Last updated
07/08/2007
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