Organization
KELLY FAMILY ORTHODONTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GILLIAN R KELLY (ORTHODONTIST)
(207) 333-2685
Entity
Organization
Contact information
Practice address
30 MEADOWRUE DR, GLASTONBURY, CT 06033-4357
(207) 333-2685
Mailing address
30 MEADOWRUE DR, GLASTONBURY, CT 06033-4357
(207) 333-2685
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
10949
CT
Other
Enumeration date
02/07/2014
Last updated
02/07/2014
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