Individual
SEAN KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
2209 E 32ND ST, TACOMA, WA 98404-4922
(253) 593-0232
(253) 593-7216
Mailing address
5615 70TH AVENUE CT W, UNIVERSITY PLACE, WA 98467-4903
(253) 460-3384
Taxonomy
Speciality
Code
Description
License number
State
1223D0001X
Public Health Dentistry
Primary
0401007551
VA
Other
Enumeration date
12/04/2006
Last updated
07/08/2007
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