Individual
DR. KELLY CHONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
800 E MERRITT ISLAND CSWY STE 105, MERRITT ISLAND, FL 32952-3514
(321) 453-8882
Mailing address
4698 SW 158TH CT, MIAMI, FL 33185-3874
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN24177
FL
Other
Enumeration date
06/13/2019
Last updated
06/25/2019
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