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Individual

KELLY RICHARD CONWAY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S., M.S.

Contact information

Practice address
535 N 87TH ST, OMAHA, NE 68114-2801
(402) 393-2300
(402) 393-4700
Mailing address
535 N 87TH ST, OMAHA, NE 68114-2801
(402) 393-2300
(402) 393-4700

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
5278
NE

Other

Enumeration date
09/22/2011
Last updated
09/22/2011
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