Organization
DENTALIGN, P.A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHAD HOLLY KELLY D.M.D. (PRESIDENT)
(763) 420-1030
Entity
Organization
Contact information
Practice address
4630 EDGEBROOK PL, EDINA, MN 55424-1152
(763) 420-1030
(730) 420-5510
Mailing address
10617 FRANCE AVENUE S, BLOOMINGTON, MN 55431
(763) 420-1030
(430) 420-5510
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
11/15/2012
Last updated
11/15/2012
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