Organization
G SCOTT KELLY DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
G SCOTT KELLY DDS (OWNER)
(906) 428-1923
Entity
Organization
Contact information
Practice address
5 LOWRIE AVE, GLADSTONE, MI 49837-2013
(906) 428-1923
Mailing address
5 LOWRIE AVE, GLADSTONE, MI 49837-2013
(906) 428-1923
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
—
—
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Enumeration date
12/10/2024
Last updated
12/10/2024
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