Organization
KELSEY PERIODONTAL GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM PATRICK KELSEY V D.D.S., M.S. (OWNER)
(402) 934-4745
Entity
Organization
Contact information
Practice address
17785 MASON ST, SUITE 103, OMAHA, NE 68118-3526
(402) 934-4745
(402) 934-4760
Mailing address
17785 MASON ST, SUITE 103, OMAHA, NE 68118-3526
(402) 934-4745
(402) 934-4760
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
6632
NE
Other
Enumeration date
09/18/2009
Last updated
09/18/2009
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