Individual
MICHAEL KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
561 SAYBROOK RD, MIDDLETOWN, CT 06457-4791
(860) 346-9259
Mailing address
561 SAYBROOK RD, MIDDLETOWN, CT 06457-4791
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
11137
CT
Other
Enumeration date
03/26/2014
Last updated
06/13/2020
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