Individual
ANDREA JILL KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1545 POWERS FERRY RD SE, SUITE B, MARIETTA, GA 30067-9412
(770) 980-9404
Mailing address
217 MAIN ST, DESTIN, FL 32541-2503
(850) 837-7448
(850) 837-2042
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN013348
GA
Other
Enumeration date
11/21/2006
Last updated
07/08/2007
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